Background Communities and researchers have called for a paradigm shift from describing health disparities to a health equity research agenda that addresses structural drivers. Therefore, we examined whether the cancer survivorship research portfolio has made this shift. Methods We identified grants focused on populations experiencing health disparities from the National Institutes of Health (NIH) Cancer Survivorship Research Portfolio (N = 724), Fiscal Years 2017–2022. Grant characteristics were abstracted, drivers of health disparities were mapped onto the levels and domains of influence, and opportunities for future research were identified. Results A total of 147 survivorship grants focused on health disparities were identified, of which 73.5% of grants focused on survivors from racial and ethnic minoritized groups, 25.9% living in rural areas, 24.5% socioeconomically disadvantaged, and 2.7% sexual and gender minority groups. Study designs were 51.0% observational. 82.3% of grants measured or intervened on at least one individual-level of influence, compared to higher levels of influence (32.7% interpersonal, 41.5% institutional/community, and 12.2% societal). Behavioral and healthcare system domains of influence were commonly represented, especially at the individual level (47.6% and 36.1%, respectively). Less frequently represented was the physical/built environment (12.2%). Conclusions NIH-funded cancer survivorship research on health disparities is still focused on individual-level of influence. However, the proportion of grants examining structural and social drivers as well as the mechanisms that drive disparities in healthcare and health outcomes among cancer survivors have increased over time. Gaps in funded research on specific populations, cancer types, and focus areas of survivorship science were identified and warrant priority.

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促进癌症生存研究中的健康公平：美国国立卫生研究院 2017-2022 年投资组合审查

背景社区和研究人员呼吁进行范式转变，从描述健康差异转向解决结构性驱动因素的健康公平研究议程。因此，我们检查了癌症生存研究组合是否已经做出了这种转变。方法 我们从美国国立卫生研究院 (NIH) 癌症生存研究组合 (N = 724) 2017-2022 财年中确定了针对经历健康差异的人群的拨款。抽象了拨款特征，将健康差异的驱动因素映射到影响水平和领域，并确定了未来研究的机会。结果 共确定了 147 份针对健康差异的幸存者补助金，其中 73.5% 的补助金针对少数种族和族裔群体的幸存者，25.9% 生活在农村地区，24.5% 为社会经济弱势群体，2.7% 为性少数群体。研究设计为观察性，占 51.0%。 82.3% 的赠款至少在一个个人层面的影响力上进行衡量或干预，而较高层面的影响力（32.7% 为人际影响力，41.5% 为机构/社区影响力，12.2% 为社会影响力）。行为和医疗保健系统的影响领域普遍存在，特别是在个人层面（分别为 47.6% 和 36.1%）。较少出现的是物理/建筑环境（12.2%）。结论 NIH 资助的关于健康差异的癌症生存研究仍然侧重于个体层面的影响。然而，随着时间的推移，研究结构和社会驱动因素以及导致癌症幸存者医疗保健和健康结果差异的机制的拨款比例不断增加。确定了针对特定人群、癌症类型和生存科学重点领域的资助研究方面的差距，并予以优先考虑。