Maloney McKenzie E, Bacak Caleb, Tjioe Kellen, Davis Loretta S, Balas E Andrew, Agrawal Gagan, Cortes Jorge E, Miranda-Galvis Marisol
Medical College of Georgia, Augusta University, Augusta, Georgia.
Georgia Cancer Center, Augusta University, Augusta, Georgia.
JAAD Int. 2024 Aug 2;17:126-138. doi: 10.1016/j.jdin.2024.07.006. eCollection 2024 Dec.
Despite recent improvements in melanoma survival rates, persistent inequalities pose barriers to care for some patients.
To assess the influence of social determinants of health (SDoH) on melanoma treatment outcomes.
A systematic review (Prospective Register of Systematic Reviews CRD42022346854) of manuscripts that examined the association between SDoH and melanoma treatment-related outcomes in the United States was conducted using 5 databases.
The analysis encompassed data from 12 retrospective manuscripts. The SDoH domains most frequently investigated were health care access and quality ( = 6 manuscripts, 50%) and economic stability ( = 7, 58.3%). Other domains included social and community context ( = 5, 41.7%) and education access ( = 3, 25%). These findings revealed significant correlations between poor melanoma survival and low levels of economic stability, limited education, government health insurance, and being uninsured and unmarried.
Many SDoH were not analyzed at the patient level. SDoH are vast categories, but manuscripts usually analyze one aspect of a particular category.
These results highlight the need for physicians to recognize the substantial impact of SDoH on melanoma outcomes and to adopt more comprehensive strategies focused on patient-centered care. Integrating social support mechanisms into clinical practice emerges as a key mechanism to promote equitable and effective interventions.
尽管黑色素瘤生存率最近有所提高，但持续存在的不平等现象给一些患者的治疗带来了障碍。
评估健康的社会决定因素（SDoH）对黑色素瘤治疗结果的影响。
使用5个数据库对研究美国SDoH与黑色素瘤治疗相关结果之间关联的手稿进行了系统综述（系统综述前瞻性注册库CRD42022346854）。
分析涵盖了12篇回顾性手稿的数据。最常研究的SDoH领域是医疗保健的可及性和质量（6篇手稿，占50%）以及经济稳定性（7篇，占58.3%）。其他领域包括社会和社区背景（5篇，占41.7%）以及教育可及性（3篇，占25%）。这些发现揭示了黑色素瘤生存率低与经济稳定性差、教育程度有限、政府医疗保险以及未参保和未婚之间存在显著相关性。
许多SDoH未在患者层面进行分析。SDoH是广泛的类别，但手稿通常只分析特定类别的一个方面。
这些结果凸显了医生认识到SDoH对黑色素瘤治疗结果的重大影响并采取更全面的以患者为中心的护理策略的必要性。将社会支持机制纳入临床实践成为促进公平有效干预的关键机制。
