The role of natural language processing in cancer care: a systematic scoping review with narrative synthesis

Abstract

Objectives: To review studies of Natural Language Processing (NLP) systems that assist in cancer care, explore use cases and summarize current research progress. Methods: A systematic scoping review, searching six databases (1) MEDLINE, (2) Embase, (3) IEEE Xplore, (4) ACM Digital Library, (5) Web of Science, and (6) ACL Anthology. Studies were included that reported NLP systems that had been used to improve cancer management by patients or clinicians. Studies were synthesized descriptively and using content analysis. Results: Twenty-nine studies were included. Studies mainly applied NLP in mixed cancer types (n=10, 34.48%) and breast cancer (n=8, 27.59%). NLP was used in four main ways: (1) to support patient education and self-management; (2) to improve efficiency in clinical care by summarizing, extracting, and categorizing data, and supporting record-keeping; (3) to support prevention and early detection of patient problems or cancer recurrence; and (4) to improve cancer treatment by supporting clinicians to make evidence-based treatment decisions. Studies highlighted a wide variety of use cases for NLP technologies in cancer care. However, few technologies had been evaluated within clinical settings, none were evaluated against clinical outcomes, and none had been implemented into clinical care. Conclusion: NLP has the potential to improve cancer care via several mechanisms, including information extraction and classification, which could enable automation and personalization of care processes. Additionally, NLP tools such as chatbots show promise in improving patient communication and support. However, there are deficiencies in the evaluation and clinical integration challenges. Interdisciplinary collaboration between computer scientists and clinicians will be essential if NLP technologies are to fulfil their potential to improve patient experience and outcomes. Registered Protocol: https://doi.org/10.17605/OSF.IO/G9DSR Keywords: Natural language processing, cancer care, patient education, summarize report, record keeping, evidence-based decision making

Competing Interest Statement

The authors have declared no competing interest.

Clinical Protocols

https://doi.org/10.17605/OSF.IO/G9DSR

Funding Statement

This research was funded by the Chief Scientist Office (https://www.cso.scot.nhs.uk/) Scottish Clinical Academic Fellowship (Grant CSO-SCAF/18/02). This grant was awarded to Rosalind Adam. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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All data produced are available online at the databases listed in the paper.

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