Abstract / Summary
Abstract Background Cancer is a major contributor to preventable health inequities among Indigenous Peoples globally. While there is expanding studies on cancer incidence, screening and diagnosis, treatment access, care experiences and survival, limited attention has been paid to the resilience and strengths through which Indigenous Peoples navigate the cancer journey. The available literature reporting on cancer experiences among Indigenous peoples has identified important elements of resilience. However, no study has comprehensively mapped how the resilience factors and resources operate across levels of the social ecology. This scoping review mapped evidence on resilience in Indigenous cancer journeys and examined how resilience is constituted within social and cultural contexts. Methods Following the Joanna Briggs Institute (JBI) methodology for scoping reviews and the PRISMA Extension for Scoping Reviews (PRISMA-ScR) reporting guideline, a systematic search was conducted in Ovid MEDLINE (including PubMed), CINAHL, PsycInfo, Scopus, Emcare and Informit, supplemented by hand-searching reference lists. Studies reporting resilience-related factors among Indigenous adults with cancer were included. Data were extracted and synthesised using descriptive and thematic approaches informed by a social-ecological framework of Indigenous resilience. Results Thirty-three studies involving 1,290 Indigenous adults with cancer were included. Five interrelated domains of resilience were identified: social and relational support; spirituality and relationships with the sacred; cultural continuity and traditional practices; respectful and culturally safe relationship with healthcare professionals; and individual strength and self-efficacy. Across studies, resilience was embedded within relational, cultural and spiritual contexts rather than individual attributes alone. The respectful and culturally safe relationships with health professionals emerged as a cross-cutting factor that could strengthen or undermine resilience. Conclusions Resilience among Indigenous cancer patients and survivors is embedded within social, cultural, relational, and spiritual contexts rather than individual attributes alone. These findings challenge deficit-oriented accounts that frame Indigenous cancer experiences primarily through vulnerability and disadvantage. Cancer services should move beyond narrow approaches to cultural adaptation and instead support family involvement, cultural continuity, spiritual care, Indigenous survivorship networks, culturally safe navigation, and Indigenous-led models of care.