Systematic review of neighborhood socioeconomic indices studied across the cancer control continuum.
Systematic review of neighborhood socioeconomic indices studied across the cancer control continuum.
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人们对了解社区社会经济地位（nSES）如何影响癌症发病率或生存率有着广泛的兴趣。然而，关于所包括的项目和用于形成复合nSES指数的方法的可变性在总结与癌症的总体关联方面提出了挑战。鉴于最近呼吁在癌症差异研究中对社区社会人口学影响进行标准化测量，本系统性综述的目的是识别和比较癌症连续体（发病率，筛查，诊断，治疗，生存/死亡率）中研究的现有nSES指数，并总结种族/种族和癌症部位的相关性，以告知未来的癌症差异研究。使用PRISMA指南，在PubMed中识别了2010年至2019年期间发表的包含nSES和癌症相关关键词的同行评审文章。从75项研究中确定了24项nSES指数。总的来说，研究结果表明nSES与癌症结局之间存在显著相关性（n = 64/75研究; 85.33%），其中42/64（65.63%）调整了高度相关的个体SES因素（例如，教育）。然而，关联的方向因癌症部位、种族/民族和nSES指数而异。这篇综述强调了几个方法和概念的问题，围绕nSES测量和潜在的关联与癌症的差距。提供了有关选择nSES措施的建议，这可能有助于告知差异相关的疾病过程，并改善需要干预的弱势人群的识别。在一项全面的系统评价后，确定了24个独特的nSES指数，仅在nSES、非西班牙裔白人的癌症发病率和选定研究中心的癌症生存率之间观察到显著相关性。研究结果强调了nSES和癌症控制结果之间的复杂关联，并需要在未来的研究中对nSES测量和变量选择进行标准化。
There is extensive interest in understanding how neighborhood socioeconomic status (nSES) may affect cancer incidence or survival. However, variability regarding items included and approaches used to form a composite nSES index presents challenges in summarizing overall associations with cancer. Given recent calls for standardized measures of neighborhood sociodemographic effects in cancer disparity research, the objective of this systematic review was to identify and compare existing nSES indices studied across the cancer continuum (incidence, screening, diagnosis, treatment, survival/mortality) and summarize associations by race/ethnicity and cancer site to inform future cancer disparity studies. Using PRISMA guidelines, peer‐reviewed articles published between 2010 and 2019 containing keywords related to nSES and cancer were identified in PubMed. Twenty‐four nSES indices were identified from 75 studies. In general, findings indicated a significant association between nSES and cancer outcomes (n = 64/75 studies; 85.33%), with 42/64 (65.63%) adjusting for highly‐correlated individual SES factors (e.g., education). However, the direction of association differed by cancer site, race/ethnicity, and nSES index. This review highlights several methodologic and conceptual issues surrounding nSES measurement and potential associations with cancer disparities. Recommendations pertaining to the selection of nSES measures are provided, which may help inform disparity‐related disease processes and improve the identification of vulnerable populations in need of intervention. After a comprehensive systematic review, 24 unique nSES indices were identified with significant associations only observed between nSES, cancer incidence among non‐Hispanic Whites, and cancer survival for select sites. Findings highlight the complex association between nSES and cancer control outcomes and a need for standardized approaches to nSES measurement and variable selection in future studies.
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