Using system dynamics modeling approach to strengthen health systems to combat cancer: a systematic literature review

Dynamic cancer control is a current health system priority, yet methods for achieving it are lacking. This study aims to review the application of system dynamics modeling (SDM) on cancer control and evaluate the research quality. Articles were searched in PubMed, Web of Science, and Scopus from the inception of the study to 15 November 2023. Inclusion criteria were English original studies focusing on cancer control with SDM methodology, including prevention, early detection, diagnosis and treatment, and palliative care. Exclusion criteria were non-original research, and studies lacking SDM focus. Analysis involved categorization of studies and extraction of relevant data to answer the research question, ensuring a comprehensive synthesis of the field. Quality assessment was used to evaluate the SDM for cancer control. Sixteen studies were included in this systematic review predominantly from the United States (7, 43.75%), with a focus on breast cancer research (5, 31.25%). Studies were categorized by WHO cancer control modules, and some studies may contribute to multiple modules. The results showed that included studies comprised two focused on prevention (1.25%), ten on early detection (62.50%), six on diagnosis and treatment (37.50%), with none addressing palliative care. Seven studies presented a complete SDM process, among which nine developed causal loop diagrams for conceptual models, ten utilized stock-flow charts to develop computational models, and thirteen conducted simulations. This review’s macrofocus on SDM in cancer control missed detailed methodological analysis. The limited number of studies and lack of stage-specific intervention comparisons limit comprehensiveness. Detailed analysis of SDM construction was also not conducted, potentially overlooking nuances in cancer control strategies. SDM in cancer control is underutilized, focusing mainly on early detection and treatment. Inconsistencies suggest a need for standardized SDM approaches. Future research should expand SDM’s application and integrate it into cancer control strategies. This study systematically reviews the application of system dynamics modeling (SDM) in cancer control, aiming to assess the research quality and provide insights into the entire modeling process. The review adheres to the PRISMA guidelines and analyses studies through the Cancer Control Continuum framework and WHO cancer control stages. The study’s findings are categorized into two groups: cancer screening and diagnosis and treatment. Notably, we found that most studies were cantered on cancer screening and the diagnosis and treatment of cancer, particularly breast cancer. The results highlight the pivotal role of SDM in evaluating the effectiveness of health policies and interventions in cancer control. Furthermore, our findings underscore the need for the development of standardized research guidelines and the expansion of research into low- and middle-income countries to ensure the broader applicability of SDM in global cancer control efforts.