Background/Objectives: Breast cancer is one of the leading causes of female mortality worldwide, but significant racial and socioeconomic disparities persist in disease outcomes. This review aimed to analyze racial and socioeconomic inequalities in mortality and survival from breast cancer, identifying the impact of social risk factors on access to diagnosis and treatment.Methods: A systematic literature review and meta-analysis was performed following PRISMA guidelines. Eighteen studies published between 2014 and 2024 were included, with 11 contributing to the meta-analysis. Random-effect models were used to assess correlations between socioeconomic status, race, and clinical outcomes, including heterogeneity and publication bias analyses.Results: The strongest associations were observed between income, race, and breast cancer survival, with survival significantly worse among Black women and low-income populations (p< 0.001). Income also showed a strong positive correlation with clinical outcomes. In contrast, the overall effect on mortality was not statistically significant (p= 0.290), likely due to high heterogeneity across studies (I2= 100%). These findings suggest that structural disparities in access to healthcare and early detection substantially affect survival rates.Conclusions: Racial and socioeconomic disparities in breast cancer outcomes remain critical public health challenges. Targeted policies to expand early diagnosis and ensure equitable access to effective treatment are essential to reduce these disparities and improve survival in underserved populations.
背景/目的：乳腺癌是全球女性死亡的主要原因之一，但疾病结局仍存在显著的种族和社会经济差异。本综述旨在分析乳腺癌死亡率和生存率中的种族及社会经济不平等现象，探讨社会风险因素对诊断与治疗可及性的影响。 方法：遵循PRISMA指南进行系统性文献综述和荟萃分析，纳入2014年至2024年间发表的18项研究，其中11项参与荟萃分析。采用随机效应模型评估社会经济地位、种族与临床结局（包括生存率和死亡率）之间的相关性，并进行异质性及发表偏倚分析。 结果：收入、种族与乳腺癌生存率之间存在显著关联，黑人女性及低收入人群的生存率明显更差（p<0.001）。收入水平与临床结局呈强正相关。相比之下，对死亡率的总体影响未达到统计学显著性（p=0.290），这可能源于研究间的高度异质性（I²=100%）。这些发现表明，医疗可及性与早期检测的结构性差异显著影响生存率。 结论：乳腺癌结局中的种族和社会经济差异仍是重要的公共卫生挑战。实施针对性政策以扩大早期诊断范围、确保有效治疗的公平可及性，对于减少服务不足人群的健康差异并提升其生存率至关重要。
Racial and Socioeconomic Disparity in Breast Cancer Mortality: A Systematic Review and Meta-Analysis
肿瘤(癌症)患者之家