Oncology · Medical Literature
Determinants of Interest-Holder Perspectives Toward Post-Mortem Tissue Donation in Oncology: A Systematic Review.
Abstract
Post-mortem tissue donation (PTD) is increasingly recognised as an important resource for advancing cancer research. Developing effective recruitment strategies for PTD programs requires a thorough understanding of interest-holder perspectives, which remain insufficiently explored. This systematic review examined factors influencing patients' willingness to participate in PTD, next-of-kin's willingness to support their relative's participation, and healthcare professionals willingness to recruit for PTD programs. A systematic literature search was conducted on 19 February 2026 to identify original research studies exploring self-reported factors influencing perspectives toward PTD. Study selection, data extraction, and quality appraisal were performed independently by four reviewers. Identified factors were synthesised and categorised into five domains: ethical/existential, emotional, practical, socio-demographic/socio-economic, and disease-related. Fourteen studies were included from 11,986 records screened. Overall, attitudes toward PTD were generally favourable across interest-holders. Ethical, existential and emotional considerations, particularly altruism, reciprocity and the perceived impact on the patient-clinician relationship were associated with willingness to participate in, (support) consent to, or recruit for PTD. Reported barriers were predominantly practical, including logistical challenges, concerns regarding funeral arrangements, and limited knowledge of PTD procedures. Healthcare professionals additionally identified discomfort with end-of-life discussions and uncertainty about PTD processes as barriers to recruitment. Socio-demographic, socio-economic, and disease-related factors were reported inconsistently, with no clear pattern of association. Interest-holder attitudes toward PTD are primarily shaped by ethical, emotional, and practical considerations. The consistency of findings across interest-holder groups and cancer types supports the development of patient-centred communication strategies to facilitate the implementation of PTD programs.
Clinical relevance
What patient, next-of-kin, and healthcare professional factors influence willingness to participate in or recruit for post-mortem tissue donation (PTD) programs in oncology settings? __SNAPSHOT__ {"studyDesign":"Systematic review (qualitative evidence synthesis; meta-analysis not reported)","setting":"International; institution type not reported; literature search conducted on 19 February 2026","sampleSize":"14 studies included from 11,986 records screened; aggregate participant N not reported","population":"Three interest-holder groups: (1) oncology patients considering PTD participation, (2) next-of-kin (NOK) of patients, and (3) healthcare professionals (HCPs) involved in PTD recruitment; specific cancer types and clinical stages not reported in the available abstract","intervention":"Participation in or support for post-mortem tissue donation (PTD) programs for cancer research purposes","comparator":"Not applicable (descriptive systematic review of self-reported factors; no comparative intervention arm)","primaryOutcome":"Self-reported factors influencing willingness to participate in PTD (patients), willingness to support a relative's PTD participation (NOK), and willingness to recruit for PTD programs (HCPs), synthesised into five domains: ethical/existential, emotional, practical, socio-demographic/socio-economic, and disease-related","followUp":"Not reported (cross-sectional or single time-point assessments inferred from study design; longitudinal follow-up not described)","fundingSource":"Not reported"}
Key findings
Fourteen studies, selected from 11,986 screened records, were included in this systematic review. Overall attitudes toward PTD were reported as generally favourable across all three interest-holder groups (patients, NOK, and HCPs). The abstract identifies ethical/existential and emotional considerations — specifically altruism, reciprocity, and additional factors not fully reported due to abstract truncation — as prominent drivers of PTD perspectives. Identified factors were organised into five synthesised domains: ethical/existential, emotional, practical, socio-demographic/socio-economic, and disease-related. No quantitative effect sizes, odds ratios, pooled estimates, confidence intervals, or p-values were reported, consistent with a qualitative or narrative synthesis rather than a statistical meta-analysis. Specific barriers, the relative weighting of domains, or inter-group differences (patients vs. NOK vs. HCPs) beyond the introductory framing were not available from the provided abstract text, which was truncated prior to completion.
Practice implications
This systematic review provides a structured, multi-stakeholder framework for understanding the determinants of PTD willingness in oncology, which is clinically relevant to designing consent processes and recruitment strategies for rapid autopsy and tissue donation programs. The finding of generally favourable attitudes across interest-holders is encouraging for program development. However, because only the abstract — and a truncated version at that — was available for review, the full scope of findings, individual study characteristics, quality appraisal results, and domain-specific conclusions cannot be evaluated. Clinicians should not modify PTD recruitment practices on the basis of this summary alone; the full publication must be consulted. The five-domain synthesis framework (ethical/existential, emotional, practical, socio-demographic/socio-economic, disease-related) may serve as a conceptual scaffold for structured conversations with patients and NOK about PTD, pending review of the complete evidence. The extent to which findings apply across cancer types, disease stages, cultural contexts, and healthcare systems cannot be determined from the available information. __LIMITATIONS__ 1. Abstract truncation: The provided abstract ends mid-sentence, preventing evaluation of the complete results, barriers, HCP-specific findings, and conclusions. 2. Small included study count: Only 14 studies were included from nearly 12,000 screened records, raising questions about the volume and heterogeneity of the primary evidence base. 3. Self-report bias: All outcomes are based on self-reported willingness and attitudes, which may not predict actual donation behaviour. 4. Qualitative synthesis limitations: No pooled quantitative estimates are reported, limiting precision of effect characterisation and preventing NNT/NNH calculations. 5. Population representativeness: Specific cancer types, disease stages, cultural/geographic diversity, and inclusion/exclusion criteria of primary studies are not described in the abstract. 6. Quality appraisal methodology: Although four independent reviewers performed quality appraisal, the appraisal tool(s) used and the distribution of study quality ratings are not reported. 7. Generalisability: Applicability to specific healthcare systems, low- and middle-income countries, and non-oncology PTD contexts is not established. 8. Funding source not reported, precluding assessment of potential conflicts of interest. __BOTTOM_LINE_CATEGORY__ promising_but_preliminary __BOTTOM_LINE__ This systematic review synthesises evidence suggesting that oncology patients, next-of-kin, and healthcare professionals generally hold favourable attitudes toward post-mortem tissue donation, with altruism and reciprocity emerging as key motivators across a five-domain framework. The complete findings, including barriers, HCP-specific determinants, and quality-appraised study characteristics, are not accessible from the truncated abstract alone. Clinicians developing or refining PTD recruitment strategies should consult the full publication before implementing protocol changes.