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Cancers
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Impact of Social Determinants on Cancer Care
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Impact of Social Determinants on Cancer Care

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: 15 August 2025 | Viewed by 3015

Special Issue Editor

Dr. Mohamad El Moheb

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Guest Editor
Department of Surgery, University of Virginia, Charlottesville, VA, USA
Interests: community distress; stress genomics; social determinants of health; cancer disparities; socioeconomic status; health equity; cancer outcomes

Special Issue Information

Dear Colleagues,

Cancer care disparities remain a critical challenge in oncology, deeply rooted in the complex interplay of social determinants of health (SDOH). These determinants, encompassing socioeconomic status, education, neighborhood environment, and social support networks, profoundly influence the entire spectrum of cancer care. Socioeconomic disadvantages often lead to delayed diagnoses and reduced access to advanced treatments, resulting in poorer clinical outcomes. Moreover, geographic and environmental factors contribute to disparities, with residents of deprived areas facing higher exposure to carcinogens and limited access to specialized care facilities.

The impact of SDOH extends beyond clinical outcomes, significantly affecting patients' quality of life and overall well-being. Financial outcomes from cancer treatment can exacerbate existing socioeconomic challenges, creating a cycle of disadvantage. Additionally, SDOH influence patient-centered outcomes, such as treatment adherence, symptom management, and psychosocial well-being. Patients from marginalized communities often experience greater stress and reduced social support, which can negatively impact their cancer journey from diagnosis through to survivorship.

Despite extensive research, significant knowledge gaps persist in understanding the complex relationship between SDOH and cancer care. Important areas that remain underexplored include the bidirectional relationship between cancer care and socioeconomic status, and the emerging field of stress genomics in oncology. The impact of transportation barriers on cancer care continuity and outcomes represents another critical, yet understudied, area. Additionally, the influence of SDOH on cancer biology, long-term survivorship, and patient-reported outcomes requires further investigation. Understanding these complex interactions is crucial for developing effective interventions to address cancer care disparities.

This Special Issue will highlight the multifaceted impact of SDOH on cancer care, from prevention and diagnosis to treatment outcomes and survivorship.

Dr. Mohamad El Moheb
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • social determinants of health
  • cancer disparities
  • socioeconomic status
  • transportation barriers
  • stress genomics
  • health equity
  • cancer outcomes

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Published Papers (3 papers)

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13 pages, 620 KiB  
Article
Outcomes for Medicaid Patients with Colorectal Cancer Are Improved in Affluent Neighborhoods, but Disparities Persist
by Kaelyn C. Cummins, Mohamad El Moheb, Chengli Shen, Susan J. Kim, Russell Witt, Samantha M. Ruff and Allan Tsung
Cancers 2025, 17(9), 1399; https://doi.org/10.3390/cancers17091399 - 22 Apr 2025
Viewed by 188
Abstract
Background: Socioeconomic status (SES) significantly influences outcomes in colorectal cancer (CRC) patients, with those from low-SES backgrounds facing worse prognoses. However, living in an affluent neighborhood may mitigate some of these disparities through environmental advantages. This study investigates whether Medicaid-insured CRC patients, as [...] Read more.
Background: Socioeconomic status (SES) significantly influences outcomes in colorectal cancer (CRC) patients, with those from low-SES backgrounds facing worse prognoses. However, living in an affluent neighborhood may mitigate some of these disparities through environmental advantages. This study investigates whether Medicaid-insured CRC patients, as a proxy for low individual SES, experience better outcomes when residing in high-SES neighborhoods. Methods: Using the National Cancer Database, we examined Medicaid CRC patients, stratifying them by neighborhood SES indicators: median household income and education level. Patients in the highest and lowest quartiles of income and education were compared. Medicaid patients from the highest-SES neighborhoods were compared to the general population. Multivariable regression models analyzed 30- and 90-day postoperative mortality, overall survival (OS), and time from diagnosis to treatment initiation and surgery. Results: CRC patients in high-income neighborhoods began treatment earlier (coefficient −1.847, p = 0.015) and exhibited improved OS (HR 0.810, p < 0.001) compared to those in low-income neighborhoods, irrespective of education level. Similarly, patients in high-education neighborhoods started treatment sooner (coefficient −3.926, p < 0.001) and had better OS (HR 0.897, p < 0.001). No differences were observed in time to surgery or postoperative mortality. Despite these advantages, Medicaid patients in high-income (HR 1.130, p < 0.001) and high-education (HR 1.209, p = 0.002) areas still had worse OS compared to non-Medicaid patients. Conclusions: Higher neighborhood SES is associated with a significant survival benefit for Medicaid CRC patients, but these patients still lag behind their non-Medicaid counterparts. Understanding the mechanisms by which neighborhood SES influences cancer outcomes could inform targeted interventions to close the survival gap. Full article
(This article belongs to the Special Issue Impact of Social Determinants on Cancer Care)
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Review

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34 pages, 1208 KiB  
Review
Barriers and Nursing Strategies in Oncology Care for LGBTQIA+ People: A Scoping Review
by Gianluca Azzellino, Ernesto Aitella, Lia Ginaldi and Massimo De Martinis
Cancers 2025, 17(7), 1146; https://doi.org/10.3390/cancers17071146 - 28 Mar 2025
Viewed by 552
Abstract
LGBTQIA+ individuals with cancer face significant challenges in their interactions with nurses, which can negatively affect the quality of care, treatment adherence, and access to healthcare. Barriers such as implicit biases, discrimination, and inadequate communication skills contribute to these disparities, alongside a lack [...] Read more.
LGBTQIA+ individuals with cancer face significant challenges in their interactions with nurses, which can negatively affect the quality of care, treatment adherence, and access to healthcare. Barriers such as implicit biases, discrimination, and inadequate communication skills contribute to these disparities, alongside a lack of nursing education on gender and sexual diversity. Despite the recognized role of nurses in reducing health inequalities, knowledge about effective strategies to overcome these barriers remains fragmented. This scoping review aims to identify and categorize the main barriers affecting the nurse–patient relationship in oncology and to explore evidence-based nursing interventions that promote equitable and inclusive care. A systematic literature search was conducted between January and February 2025 in PUBMED, SCOPUS, and Web of Science, including studies published in the last 10 years. Study management was performed using Zotero (version 6.0.30), and quality assessment was conducted with the JBI Critical Appraisal Tools. Two independent reviewers screened the studies, resolving discrepancies through discussion and consensus. This review follows the PRISMA-ScR checklist and the JBI scoping review methodology. The findings will provide insights into the primary barriers, highlight effective nursing interventions, and identify gaps in education and clinical guidelines, contributing to the development of more inclusive oncology care practices. Full article
(This article belongs to the Special Issue Impact of Social Determinants on Cancer Care)
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17 pages, 594 KiB  
Review
From Diagnosis to Survivorship: The Role of Social Determinants in Cancer Care
by Abiha Abdullah, Zeyu Liu and Michele Molinari
Cancers 2025, 17(7), 1067; https://doi.org/10.3390/cancers17071067 - 22 Mar 2025
Viewed by 1659
Abstract
Social determinants of health (SDOH) profoundly influence cancer outcomes. Disparities in these areas contribute to delayed diagnoses, limited access to advanced treatments, and poorer survival rates, disproportionately affecting marginalized populations. While advancements in cancer care have improved survival, these benefits remain unevenly distributed. [...] Read more.
Social determinants of health (SDOH) profoundly influence cancer outcomes. Disparities in these areas contribute to delayed diagnoses, limited access to advanced treatments, and poorer survival rates, disproportionately affecting marginalized populations. While advancements in cancer care have improved survival, these benefits remain unevenly distributed. This review examines the impact of SDOH on cancer care across multiple domains. It highlights the ways in which structural barriers exacerbate disparities in prevention, diagnosis, and treatment. Evidence-based interventions, including Medicaid expansion, culturally tailored patient navigation programs, increased diversity in clinical trials, telemedicine expansion, and the integration of SDOH screening into oncology workflows—offer promising strategies for addressing these inequities. By integrating these strategies into clinical practice and health policy, the healthcare system can foster a more just and inclusive future for cancer treatment and survivorship. Full article
(This article belongs to the Special Issue Impact of Social Determinants on Cancer Care)
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