Department of Cancer Prevention and Control, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA.
Department of Health Policy, Management, and Leadership, School of Public Health, West Virginia University, Morgantown, WV, USA.
Med Oncol. 2024 Oct 14;41(11):284. doi: 10.1007/s12032-024-02457-8.
Non-cancer-related risk factors for secondary lymphedema were defined across four categories: co-morbidity, social determinants of health, behavioral factors, and environmental effectors. Based on rapid reviews of the literature and presentations at the ACS/LANA Lymphedema Summit, this working group categorized these risk factors according to the strength of evidence. Consensus agreement on level of evidence was achieved through one face-to-face working session and three follow-up virtual meetings. Findings elucidate strong evidence for co-morbidities, such as cardio/metabolic and vascular factors contributing to the risk for lymphedema. Evidence is low-to-moderate for social and behavioral factors and is lacking for environmental factors. Panel recommendations suggest a tailored approach to prospective surveillance when monitoring for secondary lymphedema that includes social determinants of health considering the growing awareness and evidence of these factors' influence on cancer and cancer-related morbidity.
合并症、健康的社会决定因素、行为因素和环境影响因素。基于对文献的快速回顾和在美国临床肿瘤学会/淋巴血管外科学会淋巴水肿峰会的演讲，该工作组根据证据的强度对这些风险因素进行了分类。通过一次面对面的工作组会议和三次后续的虚拟会议，达成了对证据水平的共识协议。研究结果阐明了合并症的强证据，如心血管/代谢和血管因素导致淋巴水肿的风险。社会和行为因素的证据为低至中度，而环境因素的证据则缺乏。专家组建议在监测继发性淋巴水肿时，采用一种针对特定情况的前瞻性监测方法，考虑健康的社会决定因素，因为人们对这些因素对癌症和癌症相关发病率的影响的认识和证据正在不断增加。
