The challenges and opportunities for cancer pain management in primary and community care services: a scoping review

Uncontrolled cancer pain remains one of the most common reasons for unscheduled medical care in the UK, yet primary and community care services often lack standardized approaches to management. This scoping review explored existing evidence on cancer pain management within primary and community care settings, focusing on integration strategies, barriers to access, and facilitators of equitable pain management, particularly in underserved populations. Six electronic databases were searched for studies published between 2000 and 2025. Thirty-two articles were included, encompassing systematic reviews, qualitative and quantitative studies, randomized controlled trials, and mixed-methods research. Findings were synthesized narratively under broad thematic headings. Considerable variability in pain management practices, limited GP training, workforce constraints, and fragmented communication between generalist and specialist services were identified. Digital technologies and patient education promoted better access, empowerment, and self-management, although adoption remained inconsistent. Socioeconomic inequities and digital exclusion continue to impede equitable pain control. Cancer pain management in primary care is hindered by systemic, educational, and structural barriers. Integration of pain and palliative care services, standardized assessment protocols, and targeted digital and educational interventions could enhance equity and effectiveness. Future research should evaluate integrated care models and the role of digital health in supporting community-based pain management.