Evidence mapPaperPMID 40912683Full record

Observational studyJNCI cancer spectrum2025

Political determinants of US states' screening-amenable cancer stage at diagnosis and premature cancer mortality.

Nancy Krieger, Soroush Moallef, Tori L Cowger, Jarvis T Chen, Ruchita Balasubramanian, Alecia J McGregor, Loni Philip Tabb, William P Hanage, Mary T Bassett

Abstract readObservational Study
In one paragraph

Observational study in JNCI cancer spectrum, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Nancy KriegerDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States.ORCID 0000-0002-4815-5947
Soroush MoallefDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States.ORCID 0000-0003-0339-7309
Tori L CowgerFXB Center for Health and Human Rights, Harvard University, Boston, MA, United States.ORCID 0000-0001-5359-8155
Jarvis T ChenDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States.ORCID 0000-0002-7412-1783
Ruchita BalasubramanianFXB Center for Health and Human Rights, Harvard University, Boston, MA, United States.ORCID 0000-0002-9151-9873
Alecia J McGregorDepartment of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, United States.ORCID 0000-0003-0993-4232
Loni Philip TabbDepartment of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States.ORCID 0000-0002-7601-8368
William P HanageDepartment of Epidemiology and Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA, United States.ORCID 0000-0002-6319-7336
Mary T BassettDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States.ORCID 0000-0002-7810-4163

Funding

American Cancer Society Clinical Research
6 · The paper itself

Abstract

backgroundPolitical determinants of cancer risk are largely unexplored, conceptually and empirically.

methodsObservational analysis of associations present in 2017-2021 between 5 state-level political metrics and 4 age-standardized cancer outcomes (regional and distant stage at diagnosis for breast, cervical, and colorectal cancer among screening-age adults and premature cancer mortality), overall and in standardized linear regression models adjusting for state-level poverty and medical uninsurance.

resultsIn fully adjusted models (adjusted for state-level poverty and state-level medical uninsurance variables: % working age adults [age 35-64] without medical insurance; number of years of state Medicaid expansion), each 1 SD shift toward a more liberal political ideology (measured by voting record) among elected officials in the US House of Representatives was associated with decreased risk of diagnosis with regional and distant breast and colorectal cancer (respectively: -0.76, 95% confidence interval [CI] = -1.26 to -0.25; -0.75; 95% CI = -1.5 to 0). Risk of premature cancer mortality likewise was lower, in the fully adjusted models, with each 1 SD shift toward more liberal scores for the state electoral college vote (-2.01, 95% CI = -3.68 to -0.33), the state liberalism policy index (-2.51, 95% CI = -4.48 to -0.54), and political ideology of elected officials in the US Senate (-1.93, 95% CI = -3.71 to -0.14).

conclusionOur state-level analyses suggest that political metrics are associated with preventable cancer outcomes. Efforts to reduce population burdens of cancer and inequities in these burdens could benefit from analyses of sociopolitical drivers of cancer risk across the cancer continuum.

Indexed as

Breast NeoplasmsColorectal NeoplasmsEarly Detection of CancerMortality, PrematureNeoplasmsPoliticsUterine Cervical NeoplasmsAdultFemaleHumansMaleMedicaidMedically UninsuredMiddle AgedNeoplasm StagingPoverty

Identifiers

PMID40912683
PMCPMC12547980

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.