Academic Journal
The associations between household food insecurity and cancer: A comprehensive systematic review and meta-analysis of observational studies among adults.
| Τίτλος: | The associations between household food insecurity and cancer: A comprehensive systematic review and meta-analysis of observational studies among adults. |
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| Συγγραφείς: | Jalili F; School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada. Electronic address: FJalili@dal.ca., Mah CL; School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada., Lebenbaum M; Canadian Cancer Society, Toronto, Canada., Mehrabani S; Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran., Yousefi Tanha P; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran., Ghoreishy SM; Department of Clinical Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran., Hodder S; School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada., Hajizadeh M; School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada. |
| Πηγή: | Social science & medicine (1982) [Soc Sci Med] 2026 Nov; Vol. 408, pp. 119756. Date of Electronic Publication: 2026 Aug 26. |
| Τύπος έκδοσης: | Journal Article; Meta-Analysis; Systematic Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Pergamon Country of Publication: England NLM ID: 8303205 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-5347 (Electronic) Linking ISSN: 02779536 NLM ISO Abbreviation: Soc Sci Med Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford ; New York : Pergamon, c1982- |
| Ιατρικοί όροι (MeSH): | Neoplasms*/epidemiology , Family Characteristics* , Food Insecurity*, Humans ; Observational Studies as Topic |
| Περίληψη: | Background: Household food insecurity (HFI) is a critical social determinant of health that can adversely influence cancer prevention, treatment, and survivorship, while a cancer diagnosis with its financial and functional consequences may also increase the risk of HFI. This study aimed to examine the associations between HFI and cancer-related outcomes. Methods: A systematic search was done in PubMed, Embase, Scopus, Web of Science, and Cochrane Library until July 29, 2025. Eligible studies were observational in adults (≥18 years) evaluating the associations between HFI and cancer outcomes, with effects operating in both directions. The quality assessment was done using the Newcastle-Ottawa Scale. Pooled relative effect estimate with 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup, sensitivity, and publication bias analyses were performed, and the certainty of evidence was assessed using GRADE tool. Results: Forty-four studies (n = 1,135,888 adults) from high- (United States) and middle-income (Iran and Brazil) countries met inclusion criteria. Meta-analysis of six studies (509,291 participants; nine effect sizes) showed that HFI was significantly associated with lower cancer screening uptake (pooled relative effect estimate = 0.91; 95% CI: 0.87, 0.96; I2 = 78.8%; p < 0.001). Subgroup analyses demonstrated significant associations for both colorectal cancer screening (pooled relative effect estimate = 0.83; 95% CI: 0.70, 0.98; I2 = 72.9%; p = 0.025) and breast cancer screening (pooled relative effect estimate = 0.72; 95% CI: 0.54, 0.96; I2 = 85.9%; p = 0.026). HFI prevalence reported in the included studies among cancer patients ranged from 14% to 78%, with highest rates in low-income clinical sub-populations. HFI predicted worse treatment outcomes, including higher surgical complications, longer hospital stays, increased mortality, and lower quality of life. Among cancer survivors, HFI was associated with poor diet quality, treatment non-adherence, psychosocial distress, and increased all-cause and cancer-specific mortality. Conclusions: HFI can act as a barrier to cancer screening, treatment adherence, and survivorship, thereby contributing to inequities in cancer outcomes. Integrating HFI screening and nutrition support into the continuum of oncological care, alongside the implementation of equity-driven policies, will be important to addressing survival rates and enhance the quality of life for vulnerable populations. (Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| Competing Interests: | Declaration of competing interests The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication. Michael Lebenbaum is employed by the Canadian Cancer Society, who has a team advocating for changes to the cancer-related affordability policies. |
| Contributed Indexing: | Keywords: Cancer; Household food insecurity; Meta-analysis; Screening; Survivorship |
| Entry Date(s): | Date Created: 20260902 Date Completed: 20261007 Latest Revision: 20261008 |
| Update Code: | 20261008 |
| DOI: | 10.1016/j.socscimed.2026.119756 |
| PMID: | 42685390 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1873-5347 |
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| DOI: | 10.1016/j.socscimed.2026.119756 |