Journal article
Contextual effects and cancer outcomes in the United States: a systematic review of characteristics in multilevel analyses
Annals of epidemiology, Vol.27(11), pp.739-748.e3
11/2017
DOI: 10.1016/j.annepidem.2017.10.002
PMID: 29173579
Abstract
There is increasing call for the utilization of multilevel modeling to explore the relationship between place-based contextual effects and cancer outcomes in the United States. To gain a better understanding of how contextual factors are being considered, we performed a systematic review.
We reviewed studies published between January 1, 2002 and December 31, 2016 and assessed the following attributes: (1) contextual considerations such as geographic scale and contextual factors used; (2) methods used to quantify contextual factors; and (3) cancer type and outcomes. We searched PubMed, Scopus, and Web of Science and initially identified 1060 studies. One hundred twenty-two studies remained after exclusions.
Most studies utilized a two-level structure; census tracts were the most commonly used geographic scale. Socioeconomic factors, health care access, racial/ethnic factors, and rural-urban status were the most common contextual factors addressed in multilevel models. Breast and colorectal cancers were the most common cancer types, and screening and staging were the most common outcomes assessed in these studies.
Opportunities for future research include deriving contextual factors using more rigorous approaches, considering cross-classified structures and cross-level interactions, and using multilevel modeling to explore understudied cancers and outcomes.
•A systematic review of 122 articles on cancer using multilevel modeling.•Two-level structures and census tract were the most common structure and geographic scale.•Socioeconomic status, health care access, racial/ethnic, and rural/urban were the most frequent contextual factors.•Breast and colorectal cancers and screening were the most common types and outcomes.•Future research could use more rigorous methods and assess understudied cancers.
Details
- Title: Subtitle
- Contextual effects and cancer outcomes in the United States: a systematic review of characteristics in multilevel analyses
- Creators
- Whitney E Zahnd - Office of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, ILSara L McLafferty - Department of Geography and Geographic Information Science, University of Illinois Urbana-Champaign, Urbana, IL
- Resource Type
- Journal article
- Publication Details
- Annals of epidemiology, Vol.27(11), pp.739-748.e3
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.annepidem.2017.10.002
- PMID
- 29173579
- ISSN
- 1047-2797
- eISSN
- 1873-2585
- Language
- English
- Date published
- 11/2017
- Academic Unit
- Health Management and Policy
- Record Identifier
- 9984214784602771
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