There remains a need to synthesize linkages between social determinants of health (SDOH) and cancer screening to reduce persistent inequities contributing to the US cancer burden. The authors conducted a systematic review of US-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. Five databases were searched for peer-reviewed research articles published in English between 2010 and 2021. The Covidence software platform was used to screen articles and extract data using a standardized template. Data items included study and intervention characteristics, SDOH intervention components and measures, and screening outcomes. The findings were summarized using descriptive statistics and narratives. 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 percentage points). The objective of most interventions was 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 zero intervention components, respectively). Studies that included 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. 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 US screening inequities.

中文翻译：

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健康的社会决定因素和美国癌症筛查干预措施：系统评价


仍然需要综合健康社会决定因素 (SDOH) 和癌症筛查之间的联系，以减少造成美国癌症负担的持续不平等。作者对美国的乳腺癌、宫颈癌、结直肠癌和肺癌筛查干预研究进行了系统回顾，总结了在干预措施中如何考虑 SDOH 以及 SDOH 与筛查之间的关系。检索了 5 个数据库，查找 2010 年至 2021 年间以英文发表的同行评审研究文章。Covidence 软件平台用于筛选文章并使用标准化模板提取数据。数据项目包括研究和干预特征、SDOH 干预组成部分和措施以及筛查结果。使用描述性统计和叙述总结了研究结果。该综述纳入了针对不同人群的 144 项研究。 SDOH 干预措施使总体筛查率中位数提高了 8.4 个百分点（四分位数间距为 1.8-18.8 个百分点）。大多数干预措施的目标是增加社区需求（90.3%）和筛查机会（84.0%）。与医疗保健获取和质量相关的 SDOH 干预措施最为普遍（227 个独特的干预措施）。其他 SDOH，包括教育、社会/社区、环境和经济因素，则不太常见（分别为 90、52、21 和零干预成分）。包括对卫生政策、获得医疗服务和降低成本的分析在内的研究得出了与筛查结果有利的最大比例。 SDOH 主要在个人层面进行测量。 本综述描述了在癌症筛查干预措施的设计和评估中如何考虑 SDOH 以及 SDOH 干预措施的效果大小。研究结果可能会指导未来旨在减少美国筛查不平等的干预和实施研究。