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. This review looked at the published research evidence about how people with cancer pain are supported by GPs and community health services. Many people with cancer live with ongoing pain, and when it is not managed well, they often need emergency or out-of-hours medical help. The review found that there is no single, consistent way to manage cancer pain in GP and community settings. Doctors, nurses and other healthcare professionals often do not have enough training or time to assess and treat pain properly. It can also be hard for them to get advice from pain or palliative care specialists. This means some people wait too long for the right treatment and often access to care is unequal across different sections of the community. People living in poorer areas or rural communities may find it harder to get help, especially if they have difficulty traveling to appointments or using online health services. We found that cancer pain can be managed better when patients, families, and healthcare teams work together. Education and support can help people understand their pain, use their medicines safely, and know when to ask for help. Digital tools such as online appointments or pain-monitoring apps can also make care easier to access if people are given the right support to use them. The review concludes that cancer pain care should have a more joined-up approach across different services, with clearer guidance, more training for healthcare staff, and fair access for everyone, wherever they live.