Abstract:
Addressing the need for more equitable cardio-oncology care requires attention to existing disparities in cardio-oncologic disease prevention and outcomes. This is particularly important among those affected by adverse social determinants of health (SDOH). The intricate relationship of SDOH, cancer diagnosis, and outcomes from cardiotoxicities associated with oncologic therapies is influenced by sociopolitical, economic, and cultural factors. Furthermore, mechanisms in cell signaling and epigenetic effects on gene expression link adverse SDOH to cancer and the CVD-related complications of oncologic therapies. To mitigate these disparities, a multifaceted strategy is needed that includes attention to health care access, policy, and community engagement for improved disease screening and management. Interdisciplinary teams must also promote cultural humility and competency and leverage new health technology to foster collaboration in addressing the impact of adverse SDOH in cardio-oncologic outcomes.
摘要:
解决对更公平的心脏肿瘤护理的需求需要注意心脏肿瘤疾病预防和结果方面的现有差异。这在受健康不利社会决定因素(SDOH)影响的人群中尤为重要。SDOH的复杂关系,癌症诊断,与肿瘤治疗相关的心脏毒性的结果受社会政治影响,经济,和文化因素。此外,细胞信号传导机制和表观遗传效应对基因表达的影响将不良SDOH与癌症和肿瘤治疗的CVD相关并发症联系起来.为了减轻这些差距,需要一个多方面的战略,包括关注获得医疗保健,政策,和社区参与以改善疾病筛查和管理。跨学科团队还必须促进文化谦逊和能力,并利用新的健康技术来促进合作,以解决不良SDOH对心脏肿瘤结果的影响。