Family environment variables and related health outcomes in children and adolescent and younger adults affected by cancer: a scoping review

Children, adolescents, and younger adults (AYAs, 0, 24 years) affected by cancer often experience substantial physical and psychological symptom burden. The family environment may be an important yet underused and modifiable factor that supports physical functioning and psychological well-being. However, existing evidence remains fragmented and has not been comprehensively mapped. This scoping review aimed to identify: (1) the family environment characteristics examined in pediatric and AYA cancer research, and (2) the health outcomes associated with these factors. We searched PubMed, Web of Science, PsycINFO, and Scopus between January 6 and April 18, 2025, and identified 764 records. After full-text review, 24 studies met inclusion criteria. Most studies were cross-sectional (n = 19) and quantitative (n = 23), with one experimental study. Family environment variables were grouped into two categories: family process and relational factors, such as family functioning, and sociodemographic and contextual factors, such as socioeconomic status. Health outcomes were categorized as psychological or physical, although most studies focused on psychological outcomes. Across studies, more supportive family environments, including stronger family functioning, better socioeconomic conditions, and better parental mental well-being, were generally associated with improved psychological well-being and higher physical functioning. Most studies emphasized family process and relational factors, while relatively few examined sociodemographic and contextual factors. Similarly, psychological outcomes were assessed more often than physical functioning and health-related behaviors, such as smoking, substance use, or screen time. Interpretation is limited because most studies were cross-sectional, relied on self-report data, and were not guided by explicit theoretical frameworks. Still, the overall findings suggest that family-focused strategies may be promising for improving symptom management and well-being among children and AYAs affected by cancer.