Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bldg. 37/Room 3050, Bethesda, MD, 20892-4258, USA.
Cancer Causes Control. 2023 Mar;34(3):191-203. doi: 10.1007/s10552-022-01664-w. Epub 2022 Dec 23.
Low socioeconomic status (SES) is associated with early onset of chronic diseases and reduced life expectancy. The involvement of neighborhood-level factors in defining cancer risk and outcomes for marginalized communities has been an active area of research for decades. Yet, the biological processes that underlie the impact of SES on chronic health conditions, such as cancer, remain poorly understood. To date, limited studies have shown that chronic life stress is more prevalent in low SES communities and can affect important molecular processes implicated in tumor biology such as DNA methylation, inflammation, and immune response. Further efforts to elucidate how neighborhood-level factors function physiologically to worsen cancer outcomes for disadvantaged communities are underway. This review provides an overview of the current literature on how socioenvironmental factors within neighborhoods contribute to more aggressive tumor biology, specifically in Black U.S. women and men, including the impact of environmental pollutants, neighborhood deprivation, social isolation, structural racism, and discrimination. We also summarize commonly used methods to measure deprivation, discrimination, and structural racism at the neighborhood-level in cancer health disparities research. Finally, we offer recommendations to adopt a multi-faceted intersectional approach to reduce cancer health disparities and develop effective interventions to promote health equity.
低社会经济地位（SES）与慢性疾病的早期发病和预期寿命缩短有关。几十年来，邻里层面的因素在确定边缘化社区的癌症风险和结果方面一直是研究的活跃领域。然而，SES 对慢性健康状况（如癌症）的影响背后的生物学过程仍知之甚少。迄今为止，有限的研究表明，慢性生活压力在 SES 较低的社区更为普遍，并且可能会影响肿瘤生物学中涉及的重要分子过程，如 DNA 甲基化、炎症和免疫反应。目前正在努力阐明邻里层面的因素如何在生理上对处境不利社区的癌症结果产生不利影响。这篇综述概述了当前关于邻里环境因素如何导致更具侵袭性的肿瘤生物学的文献，特别是在美国黑人男女中，包括环境污染物、邻里贫困、社会隔离、结构性种族主义和歧视的影响。我们还总结了在癌症健康差异研究中衡量邻里剥夺、歧视和结构性种族主义的常用方法。最后，我们提出了一些建议，以采用多方面的交叉方法来减少癌症健康差异，并制定有效的干预措施来促进健康公平。
