The Relationship between Social Determinants of Health (SDOH), Cancer Screening Behavior and Cancer Stage at Diagnosis among Black Individuals: A Systematic Literature Review

Author(s): Sara Murphy


Adverse outcomes of cancer can be mitigated if tumors are identified and managed early; thus, cancer screening is crucial. This review examined the relationship between social determinants of health (SDOH), cancer screening behavior, and cancer stage at diagnosis, specifically focusing on Black individuals.


A systematic literature search was conducted for articles published up to 1st July 2023. PubMed, Scopus, ScienceDirect, and Google Scholar index databases were used. The identified studies were subjected to the study selection process.


3,897 articles were identified from the databases; however, only 19 were included in this systematic review. The SDOH factors influencing screening adherence were grouped into themes. (1) Healthcare access and quality: Health insurance, proper provider communication, knowledge about screening procedures, and recommendations for screening from doctors were found to influence the intention to undergo screening positively. (2) Education access and quality: the higher the level of educational attainment, the higher the likelihood of undergoing screening. (3) Economic stability: A higher income level is associated with higher screening rates. (4) Neighborhood and built environment: High rates of racial segregation negatively impact the intention to screen, whereas high levels of perceived neighborhood safety and community satisfaction improve screening behavior. (5) Social and community context: Having family support, religious beliefs, and supportive social networks leads to increased cancer screening rates.


Several SDOH factors affect cancer screening adherence in Black individuals. These social, economic, and cultural factors can be leveraged to improve cancer screening rates and ultimately reduce adverse cancer outcomes among Black individuals.

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