Tools for Identifying Social Determinants of Health in Head and Neck Cancer: A Scoping Review.

Abstract

Adverse social determinants of health (SDoH) are associated with disparities in head and neck cancer (HNC) and lead to delayed diagnosis and treatment. Despite this recognized association, there is limited research assessing SDoH identification tools within HNC care. To summarize existing literature on SDoH identification tools used for patients with HNC in the US and characterize the scope of domains assessed by these tools. A scoping review was conducted using the Medline, Embase, and Web of Science databases through February 9, 2026. Studies were included if they reported on SDoH identification tools studied in HNC care in the US. Inclusion criteria required that tools be applied in clinical settings and include data relevant to patients with HNC. Data were analyzed on September 5, 2024, and February 15, 2026. Seven studies published between August 2019 and October 2024 met inclusion criteria (512 patients), identifying 5 unique SDoH identification tools (Comprehensive Score for Financial Toxicity, Financial Distress Questionnaire, Patient Satisfaction Questionnaire, and NCCN Distress Thermometer Problem List). These tools were categorized based on the 5 key domains outlined by Healthy People 2030. Among the identified tools, survey items assessed 4 domains: economic stability, social and community context, health care access and quality, and neighborhood and built environment. Four of 5 tools only assessed 2 domains or fewer, and 1 tool assessed 3 domains. Economic stability was the most commonly examined domain across the 4 tools. This scoping review highlights a substantial lack of validated SDoH identification research within patient populations with HNC. Existing tools capture a limited scope of SDoH domains, which may hinder efforts to address existing disparities in HNC care. Future research should focus on assessing the use of SDoH instruments in guiding the integration of SDoH screening into routine clinical care and targeted follow-up interventions aimed at improving equity in HNC outcomes.