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Social determinants of health and U.S. cancer screening interventions: a systematic review
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2023
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Source: CA Cancer J Clin. 73(5):461-479
[PDF-781.24 KB]
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Alternative Title:CA Cancer J Clin
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Description:Background:
There remains a need to synthesize linkages between social determinants of health (SDOH) and cancer screening to reduce persistent inequities contributing to the U.S. cancer burden. We conducted a systematic review of U.S.-based breast, cervical, colorectal, and lung cancer screening intervention studies to summarize how SDOH have been considered in interventions and relationships between SDOH and screening.
Methods:
We searched five databases for peer-reviewed research articles published in English between 2010–2021. We used Covidence to screen articles and extracted data using a standardized template. Data items included study and intervention characteristics, SDOH intervention components and measures, and screening outcomes. We summarized findings using descriptive statistics and narratives.
Results:
The review included 144 studies among diverse population groups. SDOH interventions increased screening rates overall by a median of 8.4 percentage points (interquartile interval=1.8–18.8). Most interventions aimed to increase community demand (90.3%) and access (84.0%) to screening. SDOH interventions related to health care access and quality were most prevalent (227 unique intervention components). Other SDOH, including educational, social/community, environmental, and economic factors, were less common (90, 52, 21, and 0 intervention components, respectively). Studies including analyses of health policy, access to care, and lower costs yielded the largest proportions of favorable associations with screening outcomes. SDOH were predominantly measured at the individual-level.
Conclusions:
This review describes how SDOH have been considered in the design and evaluation of cancer screening interventions and effect sizes for SDOH interventions. Findings may guide future intervention and implementation research aiming to reduce U.S. screening inequities.
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Pubmed ID:37329257
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Pubmed Central ID:PMC10529377
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Volume:73
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Issue:5
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