Abstract：
The underutilisation of radiation therapy (RT) is contributing to the significant global burden of cancer with studies identifying actual utilisation rates are significantly lower than evidence-based optimal utilisation rates. Attributing factors vary considerably, ranging from patient preference, referrer bias, to geographic variations. The aim of this scoping review is to map and synthesise the current literature reporting on barriers and facilitators influencing utilisation of RT globally. Four online databases; Medline, Embase, Scopus and CINAHL identified articles dated between 1993 and 2023. Study eligibility included reporting on RT services, specifically barriers and influences on utilisation of RT. Title and abstract screening, followed by full text review was performed as per PRISMA guidelines. Variables were extracted and categorised into patient, health professional (HP) and department level influences. In total, 340 studies were included in the scoping review. HP influences (included in this specific review) were reported in 225 (66 %) papers with the most prevalent HP influence being referral (n = 187; 83 %). Of the HP papers, 114 (51 %) identified knowledge and education as an influence on RT utilisation. Subsequently, role interpretation, describing the assumed role adopted by the General Practitioner as the patients advocate, educator, manager or carer was identified in 89 (40 %) studies. This scoping review demonstrates the range of factors impacting RT utilisation. The results suggest referrer knowledge and understanding gaps impact RT utilisation internationally. Future research and intervention into referrer RT education is required to limit the impact of such influences.
摘要：
放射治疗（RT）的未充分利用导致了全球癌症的巨大负担，研究发现实际利用率显着低于基于证据的最佳利用率。归因因素差异很大，从患者偏好，引荐者偏见，地理差异。本范围审查的目的是绘制和综合有关影响全球RT利用的障碍和促进因素的最新文献报告。四个在线数据库；Medline，Embase,Scopus和CINAHL确定了1993年至2023年之间的文章。研究资格包括RT服务报告，特别是对RT利用的障碍和影响。标题和摘要筛选，随后按照PRISMA指南进行全文审查.提取变量并将其分类为患者，卫生专业人员(HP)和部门层面的影响。总的来说,340项研究纳入范围审查。在225篇（66％）论文中报告了HP影响（包括在此特定综述中），其中最普遍的HP影响是转诊（n=187；83％）。在惠普的论文中，114人(51%)认为知识和教育对RT利用有影响。随后，角色解读,描述全科医生作为患者倡导者所承担的角色，教育家,在89项(40%)研究中确定了管理者或护理人员。此范围审查显示了影响RT利用率的因素范围。结果表明，引荐者的知识和理解差距会影响国际上的RT利用。需要对推荐RT教育进行未来的研究和干预，以限制此类影响的影响。
