ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026
Social determinants drive lymphedema severity and treatment adherence: evidence from a three-year retrospective cohort study.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeLymphedema is a chronic and progressive condition that significantly affects functional outcomes and quality of life. Social determinants of health (SDOH) contribute substantially to health disparities; however, their association with lymphedema severity and treatment adherence remains underexplored. This study aimed to evaluate the association between SDOH and both lymphedema severity and adherence to therapy.
methodsA retrospective chart review was conducted on 300 patients diagnosed with lymphedema (ICD-10: I89.0) who received care at the Georgia Cancer Center between March 2019 and December 2023. SDOH variables were categorized across five domains: economic stability, education, healthcare access, neighborhood environment, and social/community context. Lymphedema severity was assessed using the International Society of Lymphology staging system and dichotomized as moderate or less versus severe. Treatment adherence was measured as a composite score (0-100%) based on four components of complete decongestive therapy and categorized as low (< 50%) or high (≥ 50%). Multivariable logistic regression was used to examine associations.
resultsAmong 295 eligible patients included in the final analysis, transportation access, ethnicity, and gender were significantly associated with both lymphedema severity and treatment adherence (p < 0.05). Limited transportation access and lower socioeconomic indicators were associated with higher odds of severe lymphedema and lower adherence. African American ethnicity and male gender were also associated with worse outcomes.
conclusionsSDOH significantly influences lymphedema severity and treatment adherence. Addressing barriers such as transportation and socioeconomic disparities is critical to improving outcomes and reducing inequities in lymphedema care.
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