OBJECTIVES: Sociodemographic factors, such as race, ethnicity, gender, age, geography, socioeconomic, or insurance status, may lead to differences in access to adequate treatment. These differences become more critical in case of life-threatening conditions such as cancers, that require timely interventions to ensure optimal outcomes. A systematic literature review was conducted to collect and analyze non-medical factors that influence treatment disparities among patients with cancer.

METHODS: Searches on Embase and MEDLINE databases were conducted on June 6, 2023, to identify studies analyzing the effect of non-medical or non-clinical (sociodemographic or economic) factors on treatment patterns among patients with cancer. Studies meeting the review's inclusion criteria, published in English from 2012 onwards were selected.

RESULTS: Among 1045 records reviewed, 337 reports analyzing treatment patterns in over 66 oncologic indications were included in the review. Demographic characteristics such as age, sex, and race/ethnicity, were most frequently analyzed (145/337, 43%). Among these, 59% (85/144) and 19% (28/144) reported the effect of race/ethnicity or sex on treatment selection, respectively. Social factors such as income, education level, socioeconomic status, insurance type, and marital status were assessed in 27% studies. Other factors such as the type of treatment center or the distance from treatment center were reported in 24% (82/337) studies. Among the 337 reports, 175 (52%) reported non-medical factors associated with not receiving curative treatment or no treatment at all: demographic characteristics in 136 reports (40%), social factors in 98 reports (29%), and other factors in 76 reports (23%). Non-medical factors impacting the patterns of care were also associated with increased mortality.

CONCLUSIONS: Majority of non-medical factors that influence treatment patterns were demographic and socioeconomic characteristics. Sociodemographic factors have also an important influence on the receipt or access to curative treatment or any cancer treatment at all and should therefore be considered while implementing healthcare policies.