Cancer remains a leading cause of morbidity and mortality globally, making it a major problem of public health concern [1]. According to the Global Cancer Observatory (GLOBOCAN), about 20 million new cases of cancer and about 10 million cancer-related deaths were recorded globally in the year 2020 alone [1]. Despite numerous public health efforts to improve awareness and limit the rising global epidemiological burden of cancer, late cancer diagnosis remains common in many countries of the world especially in low- and middle-income countries (LMICs) due to low levels of cancer literacy, low socio-economic status, and poor access to healthcare [2].

The socio-economic burden of cancer on the global economy, especially in the LMICs, is very heavy; hence, there is a need to promote preventative strategies against cancer. Public education on cancer remains an indispensable strategy that can be adopted to promote healthy behaviors and enhance early and prompt cancer diagnosis and treatment [2]. Notably, empirical evidence has proven that conventional/non-digital education-based strategies, such as the use of print-based information, education, and communication (IEC) materials (e.g., posters, leaflets, pamphlets) have been effective in improving knowledge on cancers [3]; however, these strategies were found to have inferior successes, when it comes to the effectiveness of learning and information retention when compared with digital education-based strategies [4].

In the field of cancer education, the use of serious games is one of the emerging digital-based strategies used for delivering public education on cancer [4]. Through engagement with serious games on cancer, users could acquire basic knowledge of the case definition, risk factors, symptoms, and preventive and treatment options for cancer. Their immersive and interactive features promote the understanding of the crucial elements of the educational material [4]. From a public health perspective, the adoption of serious games in educating the lay public about cancer is very promising, especially among young people due to their excellent adaptability to newer technologies and their access to these serious games [5]. Therefore, serious games have been continuously studied within the context of cancer prevention, cancer care, and cancer education for the purpose of limiting the global epidemiological burden of cancer. According to previous reports, there are over 3 billion digital game users worldwide, the majority of whom are young people [6, 7] underscoring the potential of serious games in delivering cancer education among this population.

A serious game is defined as an entertaining game designed for specific educational purposes [5]. Serious games create an entertaining learning platform as well as simulate real-life situations for their players to achieve a change in behaviors [8, 9]. Historically, the term “serious game” was popularized in the digital context in the early 2000s when it was conceived to train individuals on specific tasks in the military, business, and education despite appearing as a medium of public education as early as the 1970s [10]. However, in the last decade, there has been progressive growth in the development of serious games in the field of health, especially in the training of health professionals, patients’ education, and patients’ care [11]. This intervention strategy may be a potential game changer in cancer education due to its uniqueness, particularly in users’ motivation. In fact, compared with conventional methods of cancer education, serious games enhance better information retention. Thus, promoting early detection of symptoms, enhancing self-examination, and instilling adherence to therapies and rehabilitation among people receiving cancer care [8, 9, 12].

This commentary discusses serious games as a game changer in the different cancer education domains including cancer prevention, cancer health-seeking intentions, cancer advocacy, cancer risk awareness, and cancer-related complications as well as the factors that might limit their use and availability in resource-limited settings.

Over the years, serious games have continued to revolutionize the learning experience in various fields including the military [13], healthcare [14], and business fields [15]. Serious games have the capacity to simulate real-life combative situations in the training of soldiers to improve their decision-making, particularly in unfamiliar and complex operational environments. Hence, their adoption in the military. The users of such serious games are made to detect rule changes in the game world and make decisions accordingly for simulation in real-life scenarios [12]. Also, the use of serious games in healthcare and particularly in cancer education is growing and has been employed in various domains including cancer prevention, cancer control, and cancer care to achieve behavioral change [12, 14, 16, 17]. The following discusses the principal areas of cancer education that can be positively impacted through the adoption of serious games.

Despite the acclaimed superiority of serious games in cancer education, notable limitations have been reported in their use. Firstly, the development of serious games requires huge financial and technological resources which may not be readily available in the LMICs [36]; therefore, the adoption of this technology in resource-limited regions of the world would be limited, largely due to poor access to stable internet facilities, suitable devices and required technical support. Secondly, most serious games are designed for specific learning purposes and may not be adjustable to suit other learning situations; therefore, the versatility of serious games in advancing cancer education may be limited [37]. In addition, the conceptualization, designing, and standardization of a feasible and cost-effective serious game requires a multidisciplinary and rigorous process that involves collective input from computing and gaming experts, clinicians, and health education experts, as well as specialized software [17]. Unfortunately, the required skilled personnel needed for serious game co-production is scarce in many regions, especially in underserved communities, this therefore renders the use of serious games for cancer education in these regions relatively inaccessible when compared to conventional educational strategies on cancer [38].

Furthermore, there is still limited research evidence on the ethical implications of the use of serious games for health including their risks and benefits [39]. Hence, its adoption may be questionable in societies where the legal implications of interventions are considered with stringent rules.

Finally, there is limited research evidence on the scalability (the ability of the games to reach large audiences), especially in diverse and large populations [40]. Therefore, their adoption by healthcare providers and the public may be limited.

The future of serious games in patients’ education and empowerment, especially in cancer prevention and cancer care, is very promising [5]. Therefore, an extensive study including a longitudinal study with a large sample size and diverse study population as well as evidence from randomized controlled trials and systematic reviews will be required to comprehensively determine the effectiveness of serious games interventions among the oncology population. Hence, more empirical studies are needed for the understanding of serious game interventions in cancer education.

Also, the economic implication of developing a serious game is very heavy [36], and this cost could be burdensome on regions within the LMICs, therefore, funding through non-governmental organization (NGO) partnerships, government interventions and policies, and public-private partnerships for training of healthcare professionals on the evaluation of serious games for healthcare purposes as well as the development of digital health interventions like the serious games will be highly desirable. This will promote their availability to end users regardless of socio-economic status and location.

Furthermore, the utilization of a standardized and recognized framework in the design of serious games is currently not clear in the literature [41, 42]. Hence, there is no generally acceptable guideline for the development or evaluation of serious games. It is believed that this framework will guide game-based researchers, game designers, content experts, clinicians, and educators through a collaborative process during the design of the games to ensure the incorporation of relevant learning content for the intended end-users to ensure effective education and limit their risk of failure. The guidelines will also make replication of studies easier to obtain more consistent results.

Finally, the approach to ensuring game diversity has not been thoroughly investigated in the literature [43]. Hence, future game designs may target ensuring diversity and meeting user preferences. This may necessitate the creation of a wider range of interventions to manage user expectations. Therefore, more work is required in developing games that are specific to individual patients’ needs which can be easily integrated into the existing healthcare system.

Despite their limitations, the use of serious games remains a superior intervention strategy and a game changer in the field of cancer education. However, more research work is required to better harness their potential in improving cancer prevention and control among the global population.