Shen Han, Vos Robert O, Liu Lihua
Spatial Sciences Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA.
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
J Racial Ethn Health Disparities. 2025 Apr 21. doi: 10.1007/s40615-025-02439-0.
Ethnic enclaves (EEs) are culturally distinct neighborhoods, and complex relationships may exist between living in EEs and cancer outcomes. Given the increasing demographic diversity, expansion of EEs, and ongoing burden of cancer in the U.S., a growing body of literature focuses on the enclave-cancer relationships. This review aims to describe the scope, assess methods, synthesize existing evidence, and identify research gaps on this topic.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we found 34 empirical studies, published between January 2000 and May 2023, that examined how living in EEs may relate to various cancer outcomes, including incidence, diagnosis, treatment, and survival.
Most studies examined the relationships between residing in Hispanic or Asian enclaves and cancer incidence or survival in California. Studies used divergent methods to identify EEs, and results were mixed among null, protective, and risk findings. Studies explored several cancer types, with breast and colon cancers being the most studied, and findings also varied by patients' race and ethnicity, sex, and neighborhood socioeconomic status (SES). The small number of studies limits the power to draw statistical conclusions from the existing literature.
More research is needed to adequately explore enclave-cancer relationships among diverse populations across different U.S. regions, and to comprehensively investigate potential moderators and mediators connecting EEs and cancer outcomes. Future studies may benefit from conceptualizing and operationalizing EEs based on demographic, geographic, economic, and cultural characteristics, and recognizing varying SES, immigrant concentrations, and racial/ethnic subgroup compositions across EEs.
种族飞地（EEs）是文化上独特的社区，生活在种族飞地与癌症结局之间可能存在复杂的关系。鉴于美国人口多样性不断增加、种族飞地不断扩张以及癌症负担持续存在，越来越多的文献关注飞地与癌症的关系。本综述旨在描述该主题的范围、评估方法、综合现有证据并识别研究空白。
遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南，我们找到了2000年1月至2023年5月期间发表的34项实证研究，这些研究探讨了生活在种族飞地与各种癌症结局（包括发病率、诊断、治疗和生存率）之间的关系。
大多数研究考察了居住在加利福尼亚州的西班牙裔或亚裔种族飞地与癌症发病率或生存率之间的关系。研究使用了不同的方法来识别种族飞地，结果在无关联、保护性和风险性发现之间参差不齐。研究探讨了几种癌症类型，其中乳腺癌和结肠癌研究最多，研究结果也因患者的种族和民族、性别以及邻里社会经济地位（SES）而异。研究数量较少限制了从现有文献中得出统计结论的能力。
需要更多研究来充分探索美国不同地区不同人群中的飞地与癌症关系，并全面调查连接种族飞地和癌症结局的潜在调节因素和中介因素。未来的研究可能会受益于根据人口、地理、经济和文化特征对种族飞地进行概念化和操作化，并认识到不同种族飞地之间社会经济地位、移民集中度和种族/民族亚组构成的差异。
