Determinantes sociais de saúde no diagnóstico, tratamento e assistência aos pacientes com câncer colorretal: revisão integrativa da literatura

Objectives: To analyze the influence of Social Determinants of Health on the diagnosis, treatment, and care of patients with colorectal cancer, and to discuss the implications of these influences for the formulation of public health policies. Data sources: This is an Integrative Literature Review conducted in six systematic steps, based on the PICo strategy and guided by the methodological recommendations of PRISMA (2020), adapted to the integrative approach. Study selection was performed using Rayyan software, which facilitated blind and automated screening of titles and abstracts. Searches were carried out in the LILACS, CINAHL, Web of Science, and PubMed databases, using previously defined inclusion and exclusion criteria, and a time frame from 2008 to 2024. Data extraction was conducted using the Joanna Briggs Institute Mixed Methods Appraisal Tool (JBI-MMAT), and the analysis of findings was based on the theoretical models of Social Determinants of Health proposed by Dahlgren and Whitehead (1991), and Diderichsen, Evans, and Whitehead (2001). Results: A total of 21 articles were included, of which 14 (66.7%) had level IV evidence, and 11 (52.4%) achieved the highest score on the Heterogeneous Methodologies Assessment Scale (6 points). Two main approaches were identified: "ecosocial" and "multilevel" models, dynamically integrating individual, social, and biological dimensions. A significant process of racialization of the disease was evident, highlighting the importance of intersectoral actions and effective governance to mitigate inequalities. Conclusions: The Integrative Review reaffirms the relevance of Social Determinants of Health as key elements in public health, with direct implications for the control and care of colorectal cancer.