Bygrave Annie, Whittaker Kate, Aranda Am Sanchia
Cancer Council Australia, Sydney.
Department of Nursing, University of Melbourne, Australia.
J Public Health Res. 2020 Sep 14;9(3):1711. doi: 10.4081/jphr.2020.1711. eCollection 2020 Jul 28.
High cancer mortality is a major source of burden. Population-wide programs have been developed to improve cancer outcomes, and although effective in improving outcomes overall, the socioeconomically disadvantaged population have disproportionately benefited. This systematic review evaluated interventions aimed at addressing inequalities in cancer-related outcomes between low and high socioeconomic groups within high-income countries. The Cochrane Register of Controlled Trials, EMBASE, and PubMed searches were completed in October 2018. Data extraction and quality appraisal were guided by established mechanisms. Impact of interventions, using odds ratios, with respective 95% confidence intervals were presented, where available. Sixteen studies reporting on 19 interventions were included. Seven interventions (37%) reduced socioeconomic inequalities in cancer-related outcomes, focusing on participation in cancer screening. Interventions included pre-formulated implementation intentions; GP-endorsed screening invitations; enhanced reminder letters; text message reminders; and implementation of an organised screening program. This systematic review found limited evidence on the efficacy of existing interventions that aimed to reduce inequalities in cancer-related outcomes between people living in low and high socioeconomic areas among high-income countries. Future interventions should consider the specific needs of people living in socioeconomically disadvantaged areas to improve the efficacy of an intervention.
癌症高死亡率是主要的负担来源。已制定了针对全体人群的项目以改善癌症治疗结果,尽管总体上在改善治疗结果方面有效,但社会经济地位不利的人群受益程度不成比例。本系统评价评估了旨在解决高收入国家中社会经济地位低和高的群体在癌症相关结果方面不平等问题的干预措施。2018年10月完成了对Cochrane对照试验注册库、EMBASE和PubMed的检索。数据提取和质量评估遵循既定机制。如有可用数据,呈现了干预措施的影响,采用比值比及各自的95%置信区间。纳入了16项报告19种干预措施的研究。7种干预措施(37%)减少了癌症相关结果方面的社会经济不平等,重点是参与癌症筛查。干预措施包括预先制定的实施意图;全科医生认可的筛查邀请;强化提醒信;短信提醒;以及实施有组织的筛查项目。本系统评价发现,关于旨在减少高收入国家中社会经济地位低和高的地区人群在癌症相关结果方面不平等的现有干预措施的疗效,证据有限。未来的干预措施应考虑社会经济地位不利地区人群的特殊需求,以提高干预措施的疗效。