Cancer risk and the burden of housing and energy insecurity: a scoping review

Housing and energy insecurity represent intersecting social determinants of health that shape exposure to indoor environmental carcinogens and, consequently, cancer outcomes. This scoping review examines how inadequate housing conditions and energy poverty influence cancer risk factors and outcomes, including incidence, stage at diagnosis, survival, and mortality. Guided by the Joanna Briggs Institute methodology and the PRISMA-ScR checklist, the review synthesized evidence from peer-reviewed and gray literature published between 2010 and 2025. Findings highlight consistent associations between residential radon exposure and increased lung cancer risk, as well as evidence that poorly ventilated energy-efficiency retrofits may elevate radon concentrations. Combustion-derived pollutants from solid-fuel use similarly increase cancer risk, disproportionately affecting women and low-income households. Emerging data also link particle-bound radioactivity to reduced cancer survival independent of radon exposure. Across exposures, socioeconomic disadvantage, racialized status, and energy insecurity amplify vulnerability and worsen outcomes. These findings underscore the fact that housing and energy systems are structural determinants of cancer control. Effective cancer prevention and survivorship strategies must integrate equitable energy policies, indoor air-quality protections, and targeted interventions for energy-housing-insecure populations to reduce disparities and support climate-resilient health systems.