Whitehead Russell A, Metwally Abdel R, Patel Evan A, Cyberski Thomas, Powszok Robin, Filip Peter, Papagiannopoulos Peter, Tajudeen Bobby A, Batra Pete S
Department of Otolaryngology-Head and Neck Surgery Rush University Medical Center Chicago Illinois USA.
OTO Open. 2025 Sep 12;9(3):e70163. doi: 10.1002/oto2.70163. eCollection 2025 Jul-Sep.
Literature describing disparities in chronic rhinosinusitis (CRS) often analyzes race, gender, or socioeconomic status (SES) in isolation. Analyses encompassing a comprehensive range of disparities remain lacking. We conducted a systematic review to provide a detailed characterization of the CRS disparity landscape.
A systematic review was conducted in Covidence adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A search of PubMed/MEDLINE, CINAHL, Scopus, etc. was performed for literature published through September 2024.
A total of 690 publications were identified and screened by two authors independently. In total, 26 ultimately met the inclusion criteria. Studies were classified by pertaining health disparity (race, gender, SES, age, and geographic region) and reported outcomes (incidence, severity, and treatment choice).
In total, 26 studies on CRS disparities were published from 2012 to 2024. 16 focused on SES, describing that lower SES was associated with reduced treatment adherence, resulting in poorer endoscopic findings and quality of life. 14 studies examined racial/ethnic disparities. Hispanic patients were more symptomatic than non-Hispanic patients, whereas black patients had fewer health visits, leading to worse outcomes. Other studies discussed the impact of gender, age, and/or geographic region (n = 9, 4, 4, respectively). Findings included higher symptom burden among female patients and higher CRS incidence in regions of air pollution. Only three studies proposed solutions to disparities.
Most literature on CRS disparities describes the influence of SES and race on disease presentation and progression. Other disparities related to gender, age, and geographic region were identified. Further research should uncover root causes and propose detailed solutions to advance equitable care in CRS.
描述慢性鼻-鼻窦炎（CRS）差异的文献通常单独分析种族、性别或社会经济地位（SES）。目前仍缺乏涵盖全面差异范围的分析。我们进行了一项系统综述，以详细描述CRS差异情况。
在Covidence中进行了一项系统综述，遵循系统综述和荟萃分析的首选报告项目（PRISMA）指南。对PubMed/MEDLINE、CINAHL、Scopus等进行检索，查找截至2024年9月发表的文献。
两位作者独立识别并筛选了总共690篇出版物。最终共有26篇符合纳入标准。研究根据相关的健康差异（种族、性别、SES、年龄和地理区域）和报告的结果（发病率、严重程度和治疗选择）进行分类。
2012年至2024年共发表了26项关于CRS差异的研究。16项聚焦于SES，描述较低的SES与治疗依从性降低相关，导致内镜检查结果和生活质量较差。14项研究考察了种族/民族差异。西班牙裔患者比非西班牙裔患者症状更明显，而黑人患者的医疗就诊次数较少，导致结果更差。其他研究讨论了性别、年龄和/或地理区域的影响（分别为n = 9、4、4）。研究结果包括女性患者的症状负担更高以及空气污染地区的CRS发病率更高。只有三项研究提出了差异解决方案。
大多数关于CRS差异的文献描述了SES和种族对疾病表现和进展的影响。还发现了与性别、年龄和地理区域相关的其他差异。进一步的研究应揭示根本原因并提出详细的解决方案，以推进CRS的公平治疗。
