An integrative review of barriers to actionable intersectionality in cancer research
摘要
Intersectionality has become increasingly prominent in cancer research as a framework for examining how overlapping systems of oppression—such as racism, sexism, and classism—shape cancer disparities. However, its application remains inconsistent and has had limited actionable impact. This integrative review synthesizes 77 peer-reviewed studies published between 2012 and 2025 to critically examine how intersectionality is conceptualized, operationalized, and the extent to which it has been used to inform equity-oriented interventions. A comprehensive search strategy was employed across PubMed, Web of Science, EMBASE, and the first 100 results of Google Scholar, guided by automated keyword mapping and manual refinement to ensure broad yet relevant coverage. Employing descriptive analysis, critical appraisal, and deductive thematic synthesis, the review identifies trends in study designs, analytic methods, and knowledge production. While interest in intersectionality is growing, its use is often reductive, relying on identity cataloguing or additive models. Conceptual clarity is frequently absent, with few studies addressing structural mechanisms or theorizing the relational and dynamic nature of social categories. Translation of findings into proposals for equity-oriented solutions remains uncommon, even when disparities are well documented. Three persistent challenges are identified: the use of broad, undifferentiated categories; lack of contextual specificity; and weak integration of structure and agency. To advance the field, we argue for a reconceptualization of category to capture the intersecting influences and consequences of categories—spanning personal internalization, institutional access, and systemic response. This shift offers a pathway to uncover intersectional mechanisms and support the development of actionable, equity-driven cancer interventions.