Social determinants of health and cancer screening implementation and outcomes in the USA: a systematic review protocol

Ariella R. Korn*, Callie Walsh-Bailey, Meagan Pilar, Brittney Sandler, Prema Bhattacharjee, W. Todd Moore, Ross C. Brownson, Karen M. Emmons, April Y. Oh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Background: Improving the delivery, uptake, and implementation of cancer screening to meet evidence-based recommendations is needed to reduce persistent cancer health disparities in the USA. Current national public health targets emphasize the role of social determinants of health (SDOH) on cancer screening. However, there remains a need to explicate these linkages, toward the goal of identifying and implementing effective interventions that target and address SDOH to reduce inequities in cancer screening. Methods: We will conduct a systematic review of English language peer-reviewed original research articles published between 2010 and 2021 that describe observational (qualitative and quantitative) and intervention studies conducted in the USA. In alignment with Healthy People 2030, we will include studies of breast, cervical, colorectal, and/or lung cancer screening. Guided by multiple SDOH frameworks, we will broadly define SDOH by five domain areas: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. Following systematic literature searches in five databases (Ovid MEDLINE, Embase, CINAHL, Web of Science, Cochrane Library) and piloting of screening procedures, reviewers will independently screen titles/abstracts for potential relevance. Reviewer pairs will then screen full text articles for eligibility criteria. We will extract data items from included articles, including study characteristics, cancer screening intervention information, and coding of SDOH constructs. We will assess study quality using the Mixed Methods Appraisal Tool and synthesize our findings using narrative, descriptive statistics, tables, and figures. Our approach will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) recommendations. Discussion: By completing this systematic review, we will summarize recent literature on SDOH and cancer screening, identify research gaps for inclusion of SDOH, and propose future opportunities for advancing equity in cancer screening by integrating SDOH as part of the implementation context to promote uptake, sustainability, and scale-up in the implementation of screening guidelines. Systematic review registration: PROSPERO CRD42021276582.

Original languageEnglish (US)
Article number117
JournalSystematic Reviews
Issue number1
StatePublished - Dec 2022


  • Breast cancer
  • Cancer screening
  • Cervical cancer
  • Colorectal cancer
  • Implementation science
  • Lung cancer
  • Social determinants of health
  • United States

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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