Colorectal cancer (CRC) disproportionately affects people from low socioeconomic backgrounds and some racial minorities. Disparities in CRC incidence and outcomes might result from differences in exposure to risk factors such as unhealthy diet and sedentary lifestyle; limited access to risk-reducing behaviors such as chemoprevention, screening, and follow-up of abnormal test results; or lack of access to high-quality treatment resources. These factors operate at the individual, provider, health system, community, and policy levels to perpetuate CRC disparities. However, CRC disparities can be eliminated. Addressing the complex factors that contribute to development and progression of CRC with multicomponent, adaptive interventions, at multiple levels of the care continuum, can reduce gaps in mortality. These might be addressed with a combination of health care and community-based interventions and policy changes that promote healthy behaviors and ensure access to high-quality and effective measures for CRC prevention, diagnosis, and treatment. Improving resources and coordinating efforts in communities where people of low socioeconomic status live and work would increase access to evidence-based interventions. Research is also needed to understand the role and potential mechanisms by which factors in diet, intestinal microbiome, and/or inflammation contribute to differences in colorectal carcinogenesis. Studies of large cohorts with diverse populations are needed to identify epidemiologic and molecular factors that contribute to CRC development in different populations.

中文翻译：

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结直肠癌社会经济差异的原因以及干预框架和策略。


结直肠癌 (CRC) 不成比例地影响社会经济背景较低的人群和一些少数族裔。结直肠癌发病率和结果的差异可能是由于接触不健康饮食和久坐生活方式等危险因素的差异造成的；化学预防、筛查和异常检测结果跟踪等降低风险行为的机会有限；或缺乏获得优质治疗资源的机会。这些因素在个人、医疗服务提供者、卫生系统、社区和政策层面发挥作用，导致结直肠癌的差异长期存在。然而，CRC 差异是可以消除的。通过在护理连续体的多个层面采取多成分、适应性干预措施来解决导致结直肠癌发生和进展的复杂因素，可以缩小死亡率差距。这些问题可以通过结合医疗保健和基于社区的干预措施以及政策改变来解决，以促进健康行为并确保获得高质量和有效的结直肠癌预防、诊断和治疗措施。改善社会经济地位低的人生活和工作的社区的资源并协调努力将增加获得循证干预措施的机会。还需要研究来了解饮食、肠道微生物组和/或炎症因素在结直肠癌发生差异中的作用和潜在机制。需要对不同人群的大型队列进行研究，以确定有助于不同人群中结直肠癌发展的流行病学和分子因素。