Bolaji Olayiwola, Johnson Michelle N
Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA.
Curr Cardiol Rep. 2025 Apr 8;27(1):82. doi: 10.1007/s11886-025-02229-4.
This review examines racial, ethnic, and socioeconomic disparities in cardio-oncology care, evaluating current evidence and proposing evidence-based strategies to address inequities in cardiovascular care for cancer patients.
Significant disparities exist in cardio-oncology outcomes and access across populations. Racial and ethnic minoritized groups face higher cardiovascular mortality and increased cardiotoxicity risks during cancer treatment. These populations also preset with more advanced-stage cancer diagnoses and increased burden of cardiovascular risk factors. Social vulnerability indices strongly correlate with worse outcomes, while geographic location and environmental factors create additional risks. Rural populations particularly struggle with access to specialized care and clinical trials. Multiple factors contribute to disparities in cardio-oncology, including social determinants of health, disproportionate burden of cardiovascular risk factors, barriers to access, and environmental exposures. Key solutions include expanding access to subspecialty care, creation of collaborations between academic centers and community hospitals, particularly those in underserved communities, enhancing community engagement and public health education, improving clinical trial representation, increasing workforce diversity, and enhancing cultural competency. These findings emphasize the need for systematic healthcare delivery changes and resource allocation to achieve equitable cardio-oncology care for all populations.
本综述探讨心脏肿瘤学护理中的种族、民族和社会经济差异,评估现有证据,并提出基于证据的策略,以解决癌症患者心血管护理中的不平等问题。
心脏肿瘤学的治疗结果和不同人群获得治疗的机会存在显著差异。少数族裔群体在癌症治疗期间面临更高的心血管死亡率和增加的心脏毒性风险。这些人群还表现出癌症诊断分期更晚以及心血管危险因素负担加重的情况。社会脆弱性指数与更差的治疗结果密切相关,而地理位置和环境因素会带来额外风险。农村人口在获得专科护理和参与临床试验方面尤其困难。心脏肿瘤学差异由多种因素造成,包括健康的社会决定因素、心血管危险因素负担过重、获得治疗的障碍以及环境暴露。关键解决方案包括扩大专科护理的可及性、在学术中心和社区医院之间建立合作关系,特别是在服务不足社区的医院,加强社区参与和公共卫生教育,改善临床试验代表性,增加劳动力多样性,以及提高文化能力。这些发现强调需要系统性地改变医疗服务提供方式和资源分配,以实现为所有人群提供公平的心脏肿瘤学护理。