Utility of the Social Vulnerability Index in Addressing Breast Cancer Disparities: A Meta-Analysis

To evaluate the utility of the Social Vulnerability Index (SVI) in understanding disparities in breast cancer screening, incidence, and mortality.

Despite major advances in breast cancer detection and treatment, significant disparities persist-particularly among socioeconomically and geographically vulnerable populations. The SVI, developed by the CDC, is a composite index that captures community-level vulnerability across multiple social domains and may serve as a tool to identify and address inequities in cancer care.

This systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD42024616874). PubMed, Scopus, and Embase were searched for studies examining associations between SVI and breast cancer outcomes. Studies were evaluated using the Newcastle-Ottawa Scale or appropriate Cochrane tools. Meta-analyses were performed where applicable.

Fifteen studies were included. Seven studies examined screening; a pooled meta-analysis (n = 3) showed reduced screening in high-SVI areas (pooled OR: 0.55, 95% CI: 0.24-1.26; I² = 99%). Four studies reported reduced incidence in high-SVI populations, likely reflecting underdiagnosis. Five studies demonstrated increased mortality in high-SVI populations, with ORs ranging from 1.09 to 2.84. Other studies addressed comorbidities, access to care, and disease subtypes.

The SVI is a valuable, multidimensional tool for characterizing and addressing disparities in breast cancer outcomes, with implications for public health interventions and policy.