Health Policy and Systems
Franchesca M. Inay, MD
Medical Student
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania, United States
Eric K. Chang, DO
Resident Physician
Southwest Healthcare Medical Education Consortium
Riverside, California, United States
Jordan Aldor, BS
Medical Student
A.T. Still University
Gilbert, Arizona, United States
Niña R. Carmela Tamayo, DO MS MPH (she/her/hers)
DO MS MPH
Prime Directives PM&R, Cleveland, OH and PAPA
Lakewood, Ohio, United States
Brian M. Gutierrez, MD, MS
Resident Physician
Richmond University Medical Center
National City, California, United States
Significant barriers to accessing rehabilitation services have been identified within Filipino communities. Yet, this population remains underrepresented in cancer disparities research.
Given the disproportionate burden of cancer-related disparities among Filipinos, this review identifies gaps in cancer rehabilitation across the Filipino diaspora and its impact on patients. Gaps in QoL measurements, sociocultural determinants, and disproportionate morbidity influence rehabilitation access and functional outcomes in the Filipino cancer population. This review highlights the need for further research on the barriers to cancer rehabilitation in the Philippines as well as the need for culturally tailored cancer care.
Design: A systematic review was conducted following PRISMA 2020 guidelines. Three electronic databases (WebofScience, PubMed, and Medline) were queried with the search terms “[Filipino] AND [cancer]” and “[Philippines] AND [cancer].” Primary outcomes included cancer rehabilitation metrics, namely service availability and utilization, and patient-reported quality-of-life (QoL) outcomes among Filipinos with cancer. An initial PRISMA search yielded 535 articles, and six were included for full-text review.
Results: Disparities affecting cancer rehabilitation in the Filipino population exist in three categories: inaccurate QoL representation, reduced rehabilitation engagement secondary to cultural determinants, and disproportionate morbidity resulting in pervasive debility. On standardized measurements, Filipino patients demonstrate differential item functioning in which their scores of cancer-related physical, cognitive, and social functioning are higher or lower than those of other groups. Differences in responses to QoL measurements may lead to an underestimation of functional impairments and subsequently delayed or absent referrals to rehabilitation. From a sociocultural perspective, community values like hiya (shame), pakikisama (social harmony), and bahala-na (fatalism) affect patients' choices to disclose symptoms and pursue treatment. These factors, along with heavy reliance on religion and family support, contribute to the underutilization of rehabilitation and survivorship services. Clinically, Filipinos exhibit disproportionate morbidity across multiple cancers, with survivors noting pain, fatigue, and deteriorating psychosocial health as sequelae.
Conclusion:
