Contextual effects and cancer outcomes in the United States: a systematic review of characteristics in multilevel analyses.

摘要: Abstract Purpose There is increasing call for the utilization of multilevel modeling to explore relationship between place-based contextual effects and cancer outcomes in United States. To gain a better understanding how factors are being considered, we performed systematic review. Methods We reviewed studies published January 1, 2002 December 31, 2016 assessed following attributes: (1) considerations such as geographic scale used; (2) methods used quantify factors; (3) type outcomes. searched PubMed, Scopus, Web Science initially identified 1060 studies. One hundred twenty-two remained after exclusions. Results Most utilized two-level structure; census tracts were most commonly scale. Socioeconomic factors, health care access, racial/ethnic rural-urban status common addressed models. Breast colorectal cancers types, screening staging these Conclusions Opportunities future research include deriving using more rigorous approaches, considering cross-classified structures cross-level interactions, understudied