{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:26:58Z","timestamp":1786969618985,"version":"build-2736575974"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Nutrition is increasingly recognized as a modifiable determinant of treatment tolerance, metabolic health, quality of life, and survivorship outcomes among women with cancer. However, nutrition-oriented cancer care is often delivered as an individual-level clinical recommendation, while many determinants of dietary behavior and nutritional vulnerability arise outside oncology clinics. Food insecurity, unequal food environments, limited dietitian availability, fragmented referral systems, low nutrition literacy, transport barriers, and gendered caregiving roles can prevent women with breast, cervical, ovarian, endometrial, and other cancers from receiving timely and effective nutrition support. Community governance provides a policy framework for linking oncology services with primary care, public health agencies, community organizations, food assistance programs, digital platforms, and patient groups. This Mini Review examines how community governance can strengthen nutrition-oriented cancer care for women and reduce survival disparities. We summarize pathways through which community-level conditions influence nutritional status and survivorship, distinguish established evidence from promising implementation models and expert-policy rationale, and propose governance mechanisms for nutrition screening, referral, food support, and follow-up. Community-governed nutrition care should move beyond service volume and evaluate whether nutritionally vulnerable women receive accessible, culturally appropriate, and outcome-oriented support across the cancer continuum.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1912567","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:52:39Z","timestamp":1786967559000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Community governance and nutrition-oriented cancer care for women: policy pathways to reduce survival disparities"],"prefix":"10.3389","volume":"14","author":[{"given":"Liqian","family":"Hao","sequence":"first","affiliation":[{"name":"Shanxi Normal University","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomin","family":"Ma","sequence":"additional","affiliation":[{"name":"Shanxi Engineering Vocational College","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyan","family":"Feng","sequence":"additional","affiliation":[{"name":"Shanxi Normal University","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin."},{"key":"B2","doi-asserted-by":"publisher","first-page":"230","DOI":"10.3322\/caac.21719","article-title":"American Cancer Society nutrition and physical activity guideline for cancer survivors","volume":"72","author":"Rock","year":"2022","journal-title":"CA Cancer J Clin."},{"key":"B3","article-title":"Diet, nutrition, physical activity and cancer: a global perspective","volume-title":"Continuous Update Project Expert Report.","year":"2018"},{"key":"B4","volume-title":"Diet, Nutrition, Physical Activity and Body Weight for People Living with and Beyond Breast Cancer.","year":"2024"},{"key":"B5","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.clnu.2016.07.015","article-title":"ESPEN guidelines on nutrition in cancer patients","volume":"36","author":"Arends","year":"2017","journal-title":"Clin Nutr."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2898","DOI":"10.1016\/j.clnu.2021.02.005","article-title":"ESPEN practical guideline: clinical nutrition in cancer","volume":"40","author":"Muscaritoli","year":"2021","journal-title":"Clin Nutr."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.clnu.2019.02.033","article-title":"GLIM criteria for the diagnosis of malnutrition: a consensus report","volume":"38","author":"Cederholm","year":"2019","journal-title":"Clin Nutr."},{"key":"B8","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1016\/S1470-2045(10)70218-7","article-title":"Definition and classification of cancer cachexia: an international consensus","volume":"12","author":"Fearon","year":"2011","journal-title":"Lancet Oncol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"17105","DOI":"10.1038\/nrdp.2017.105","article-title":"Cancer-associated cachexia","volume":"4","author":"Baracos","year":"2018","journal-title":"Nat Rev Dis Primers."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2491","DOI":"10.1200\/JCO.22.00687","article-title":"Exercise, diet, and weight management during cancer treatment: ASCO guideline","volume":"40","author":"Ligibel","year":"2022","journal-title":"J Clin Oncol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1901","DOI":"10.1093\/annonc\/mdu042","article-title":"Body mass index and survival in women with breast cancer\u2014systematic literature review and meta-analysis","volume":"25","author":"Chan","year":"2014","journal-title":"Ann Oncol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1577","DOI":"10.1093\/jnci\/djac135","article-title":"Food insecurity among people with cancer: nutritional needs as an essential component of care","volume":"114","author":"Raber","year":"2022","journal-title":"J Natl Cancer Inst."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e922","DOI":"10.1200\/JOP.19.00736","article-title":"Food insecurity and forgone medical care among cancer survivors","volume":"16","author":"McDougall","year":"2020","journal-title":"JCO Oncol Pract."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1830","DOI":"10.1377\/hlthaff.2015.0645","article-title":"Food insecurity and health outcomes","volume":"34","author":"Gundersen","year":"2015","journal-title":"Health Aff."},{"key":"B15","article-title":"Addressing the social needs of people with cancer","volume-title":"Cancer Currents Blog.","year":"2024"},{"key":"B16","volume-title":"Framework on Integrated, People-Centred Health Services.","year":"2016"},{"key":"B17","volume-title":"Integrating Social Care Into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health.","year":"2019"},{"key":"B18","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1111\/1468-0009.12390","article-title":"Meanings and misunderstandings: a social determinant of health lexicon for health care systems","volume":"97","author":"Alderwick","year":"2019","journal-title":"Milbank Q."},{"key":"B19","first-page":"2","article-title":"Chronic disease management: what will it take to improve care for chronic illness?","volume":"1","author":"Wagner","year":"1998","journal-title":"Eff Clin Pract."},{"key":"B20","doi-asserted-by":"publisher","first-page":"e010","DOI":"10.5334\/ijic.886","article-title":"Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care","volume":"13","author":"Valentijn","year":"2013","journal-title":"Int J Integr Care."},{"key":"B21","volume-title":"Nutrition in Cancer Care (PDQ","year":"2024"},{"key":"B22","doi-asserted-by":"publisher","first-page":"551","DOI":"10.2471\/BLT.15.164020","article-title":"Community health worker programmes after the 2013\u20132016 Ebola outbreak","volume":"94","author":"Perry","year":"2016","journal-title":"Bull World Health Organ."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1001\/jamaoncol.2022.1997","article-title":"Effect of a community health worker intervention on acute care use in advanced cancer: a randomized clinical trial","volume":"8","author":"Patel","year":"2022","journal-title":"JAMA Oncol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"CD004015","DOI":"10.1002\/14651858.CD004015.pub3","article-title":"Lay health workers in primary and community health care","volume":"2010","author":"Lewin","year":"2010","journal-title":"Cochrane Database Syst Rev."},{"key":"B25","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1001\/jamainternmed.2013.14327","article-title":"Patient-centered community health worker intervention to improve posthospital outcomes","volume":"174","author":"Kangovi","year":"2014","journal-title":"JAMA Intern Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1016\/j.amepre.2022.10.016","article-title":"Community health workers to increase cancer screening: 3 Community Guide systematic reviews","volume":"64","author":"Okasako-Schmucker","year":"2023","journal-title":"Am J Prev Med."},{"key":"B27","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.gfs.2017.07.001","article-title":"Food security governance in Latin America: principles and the way forward","volume":"14","author":"P\u00e9rez-Escamilla","year":"2017","journal-title":"Glob Food Sec."},{"key":"B28","doi-asserted-by":"publisher","first-page":"S15","DOI":"10.1016\/0899-9007(96)90011-8","article-title":"Definition of standardized nutritional assessment and interventional pathways in oncology","volume":"12","author":"Ottery","year":"1996","journal-title":"Nutrition."},{"key":"B29","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/S0261-5614(02)00214-5","article-title":"Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials","volume":"22","author":"Kondrup","year":"2003","journal-title":"Clin Nutr."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.3390\/jcm8081211","article-title":"Nutrition in cancer patients","volume":"8","author":"Ravasco","year":"2019","journal-title":"J Clin Med."},{"key":"B31","volume-title":"Community Engagement: A Health Promotion Guide for Universal Health Coverage in the Hands of the People","year":"2020"},{"key":"B32","volume-title":"Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs","year":"2008"},{"key":"B33","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1007\/s11524-012-9750-2","article-title":"Food insecurity: limitations of emergency food resources for our patients","volume":"90","author":"Gany","year":"2013","journal-title":"J Urban Health."},{"key":"B34","doi-asserted-by":"publisher","first-page":"481","DOI":"10.3945\/an.113.004119","article-title":"What are we assessing when we measure food security? A compendium and review of current metrics","volume":"4","author":"Jones","year":"2013","journal-title":"Adv Nutr."},{"key":"B35","doi-asserted-by":"publisher","first-page":"S9","DOI":"10.1002\/oby.22031","article-title":"Agenda for translating physical activity, nutrition, and weight management interventions for cancer survivors into clinical and community practice","volume":"25","author":"Basen-Engquist","year":"2017","journal-title":"Obesity."},{"key":"B36","volume-title":"Guide to Measuring Household Food Security","author":"Bickel","year":"2000"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1912567\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:52:41Z","timestamp":1786967561000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1912567\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":36,"alternative-id":["10.3389\/fpubh.2026.1912567"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1912567","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"article-number":"1912567"}}