Social determinants of colorectal cancer risk, stage, and survival: a systematic review

Int J Colorectal Dis. 2020 Jun;35(6):985-995. doi: 10.1007/s00384-020-03585-z. Epub 2020 Apr 21.

Abstract

Background: Several social determinants of health have been examined in relation to colorectal cancer incidence, stage at diagnosis, and survival including income, education, neighborhood disadvantage, immigration status, social support, and social network. Colorectal cancer incidence rates are positively associated with income and other measures of socioeconomic status. In contrast, low socioeconomic status tends to be associated with poorer survival.

Methods: The present review is based upon bibliographic searches in PubMed and CINAHL and relevant search terms. Articles published in English from 1970 through April 1, 2019 were identified using the following MeSH search terms and Boolean algebra commands: colorectal cancer AND (incidence OR stage OR mortality) AND (social determinants OR neighborhood disadvantage OR racial discrimination OR immigration OR social support).

Results: This review indicates that poverty, lack of education, immigration status, lack of social support, and social isolation play important roles in colorectal cancer stage at diagnosis and survival.

Conclusions: To address social determinants of colorectal cancer, effective interventions are needed that account for the social contexts in which patients live.

Keywords: African Americans; Colorectal cancer; Education; Immigration; Poverty; Social support.

Publication types

  • Systematic Review

MeSH terms

  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / pathology
  • Educational Status
  • Emigration and Immigration*
  • Humans
  • Income
  • Neoplasm Staging
  • Poverty Areas*
  • Risk Factors
  • Social Determinants of Health*
  • Social Isolation
  • Social Support*
  • Survival Rate