Francisco Pelegrín, Medical oncologist specialised in GI cancer working in Hospital Vega Baja OncoDaily Spain Hub, highlights the overlooked impact of social determinants in modern oncology care:
“What we don’t measure, we misinterpret: the blind spot of social determinants in oncology”
In the era of precision oncology, we pride ourselves on the depth of molecular understanding guiding cancer care. A complete oncologic history without precise documentation of performance status, molecular profile, and treatment lines is almost inconceivable. But when it comes to social determinants of health, our clinical records tell a very different story.
In a preliminary real-world analysis from our group, we observed that while clinical variables are consistently recorded, social determinants are frequently missing. In this context, social determinants referred not only to socioeconomic status, but also to living conditions, caregiver availability, educational level, employment vulnerability, language barriers, perceived social support, loneliness, and psychosocial stress. These early findings, pending prospective validation, highlight a relevant gap in routine oncology practice.
It is known that social context influences access to care, treatment adherence, and possibly survival. Yet we continue to ignore social determinants of health when establishing treatment plans for our patients. This is not just a documentation issue. It is a clinical blind spot.
As a result, a silent bias may be shaping our oncology practice. Some of the effects we attribute to tumor biology or treatment efficacy may, in part, reflect unmeasured social backgrounds. If we truly aim for personalized oncology, we cannot ignore the patient’s social environment. Because what we don’t record, we don’t treat — and what we don’t measure, we misinterpret.”