Evidence map›Paper›PMID 33929888›Full record

SynthesisCancer control : journal of the Moffitt Cancer Center

Factors Explaining Socio-Economic Inequalities in Cancer Survival: A Systematic Review.

Nina Afshar, Dallas R English, Roger L Milne

Abstract readSystematic Review
In one paragraph

Synthesis in Cancer control : journal of the Moffitt Cancer Center. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

68 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Article
  5. Article
  6. Environmental factors shaping cancer outcomes in Alabama: A scoping review.Journal of cancer survivorship : research and practice · 2026
    Review
  7. Article
  8. Article
  9. Article
  10. Consolidation radiotherapy refusal in stage I-II Hodgkin lymphoma: sociodemographic determinants and impact on survival outcomes.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026
    Article
  11. The role of socioeconomic position in use of systemic anticancer therapy.ESMO real world data and digital oncology · 2026
    Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Socioeconomic differences in labour market attachment after breast cancer: a population-based matched cohort study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  18. Sociodemographic variation in symptomatic faecal immunochemical testing return: a population-based analysis of 125 659 patients.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Article
  19. Article
  20. Article

8 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Nina AfsharCancer Epidemiology Division, 56367Cancer Council Victoria, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0001-5587-9540
Dallas R EnglishCancer Epidemiology Division, 56367Cancer Council Victoria, Melbourne, Victoria, Australia.
Roger L MilneCancer Epidemiology Division, 56367Cancer Council Victoria, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0001-5764-7268

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is strong and well-documented evidence that socio-economic inequality in cancer survival exists within and between countries, but the underlying causes of these differences are not well understood.

methodsWe systematically searched the Ovid Medline, EMBASE, and CINAHL databases up to 31 May 2020. Observational studies exploring pathways by which socio-economic position (SEP) might causally influence cancer survival were included.

resultsWe found 74 eligible articles published between 2005 and 2020. Cancer stage, other tumor characteristics, health-related lifestyle behaviors, co-morbidities and treatment were reported as key contributing factors, although the potential mediating effect of these factors varied across cancer sites. For common cancers such as breast and prostate cancer, stage of disease was generally cited as the primary explanatory factor, while co-morbid conditions and treatment were also reported to contribute to lower survival for more disadvantaged cases. In contrast, for colorectal cancer, most studies found that stage did not explain the observed differences in survival by SEP. For lung cancer, inequalities in survival appear to be partly explained by receipt of treatment and co-morbidities.

conclusionsMost studies compared regression models with and without adjusting for potential mediators; this method has several limitations in the presence of multiple mediators that could result in biased estimates of mediating effects and invalid conclusions. It is therefore essential that future studies apply modern methods of causal mediation analysis to accurately estimate the contribution of potential explanatory factors for these inequalities, which may translate into effective interventions to improve survival for disadvantaged cancer patients.

Indexed as

Health Status IndicatorsFemaleHealthcare DisparitiesHumansMaleNeoplasmsPrimary Health CareSocioeconomic FactorsSurvival Ratecancer survivaldeprivationdisadvantagedisparityinequalitysocio-economic position

Identifiers

PMID33929888
PMCPMC8204531

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.