When disaster strikes: A scoping review of climate-resilience toolkits relevant to cancer care delivery.

Abstract

e23198 Background: External disruptions, such as extreme weather and infrastructure failures,are increasingly undermining timely, access to cancer care, while guidance onmaintaining treatment continuity during such events remains scattered and may not fully address the urgent, resource-intensive needs of oncology patients. This review examined whether existing resilience toolkits adequately address the unique needs of oncology care delivery. Methods: We conducted a scoping review of peer-reviewed and grey literature toidentify healthcare resilience toolkits and guidelines relevant to external disruptions. Sources were identified through PubMed, Google Scholar, and targeted web searches between October and December 2025. Resources were included if they offered practical strategies to support healthcare system resilience and were deemed relevant to cancer care delivery. Key characteristics of each resource, including the target audience, healthcare setting, and content focus, were summarized, and themes were identified. Results: Ten resilience-focused resources met the inclusion criteria, including five formaltoolkits. None were tailored specifically to oncology care. Most resources (75%) focused on emergency preparedness and infrastructure protection, with limited attention to outpatient cancer services, treatment continuity, or patient-level access barriers. Few addressed workforce constraints, scheduling flexibility, or the needs of clinically vulnerable populations. Oncology-specific challenges—such as frequent treatment visits, narrow therapeutic windows, and coordinated multidisciplinary care—were largely absent. Conclusions: Existing resilience toolkits insufficiently address operational cancer careduring external disruptions. These results suggest the need for resilience guidelines tailored specifically for oncology, considering urgent treatments, care coordination, and equity considerations. Developing and implementing such guidance is crucial to ensuring cancer care remains effective amid growing system-level challenges.