The role of primary care in improving equity and access to cancer services in Saudi Arabia

Abstract This narrative review examines how primary care can improve equitable access to cancer services in Saudi Arabia, where cancer incidence continues to rise due to demographic transitions, lifestyle changes, and improved diagnostic detection. While secondary and tertiary oncology services have expanded nationally, primary care remains challenged in delivering consistent early cancer detection, equitable referral pathways, and guideline-based screening implementation. A structured literature search was conducted across MEDLINE, Embase, CINAHL, Google Scholar, and relevant grey literature, including Ministry of Health reports and national screening program documents. Evidence addressing physician practices, patient barriers, system-level inequities, diagnostic access, and referral processes was synthesized thematically. Findings indicate persistent underutilization of colorectal, breast, and prostate cancer screening, delays in presentation influenced by sociocultural factors, limited diagnostic capacity within primary health care centers, and regional disparities that particularly disadvantage rural populations. Evidence also suggests that inconsistent referral processes and variability in physician training contribute to inequitable cancer service access. Strengthening evidence-based screening implementation, embedding decision support tools within electronic health records, enhancing oncology training for primary care physicians, standardizing referral pathways, and implementing culturally sensitive community outreach strategies may improve early detection and equity in service delivery. Aligning these efforts with Vision 2030 health reforms offers an opportunity to reinforce a primary care–centered model of cancer prevention and early detection across the Kingdom.