Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence
Background: Previous reviews of geographical disparities in the prostate cancer continuum from diagnosis to mortality have identified a consistent pattern of poorer outcomes with increasing residential disadvantage and for rural residents. However, there are no contemporary, systematic reviews summa...
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Format: | Article |
Language: | English |
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Frontiers Media S.A.
2019-04-01
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Series: | Frontiers in Oncology |
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Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2019.00238/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Paramita Dasgupta Peter D. Baade Peter D. Baade Peter D. Baade Joanne F. Aitken Joanne F. Aitken Joanne F. Aitken Nicholas Ralph Nicholas Ralph Nicholas Ralph Suzanne Kathleen Chambers Suzanne Kathleen Chambers Suzanne Kathleen Chambers Suzanne Kathleen Chambers Jeff Dunn Jeff Dunn Jeff Dunn |
spellingShingle |
Paramita Dasgupta Peter D. Baade Peter D. Baade Peter D. Baade Joanne F. Aitken Joanne F. Aitken Joanne F. Aitken Nicholas Ralph Nicholas Ralph Nicholas Ralph Suzanne Kathleen Chambers Suzanne Kathleen Chambers Suzanne Kathleen Chambers Suzanne Kathleen Chambers Jeff Dunn Jeff Dunn Jeff Dunn Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence Frontiers in Oncology prostate cancer rural area-disadvantage health disparity systematic review geographical variations |
author_facet |
Paramita Dasgupta Peter D. Baade Peter D. Baade Peter D. Baade Joanne F. Aitken Joanne F. Aitken Joanne F. Aitken Nicholas Ralph Nicholas Ralph Nicholas Ralph Suzanne Kathleen Chambers Suzanne Kathleen Chambers Suzanne Kathleen Chambers Suzanne Kathleen Chambers Jeff Dunn Jeff Dunn Jeff Dunn |
author_sort |
Paramita Dasgupta |
title |
Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence |
title_short |
Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence |
title_full |
Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence |
title_fullStr |
Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence |
title_full_unstemmed |
Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence |
title_sort |
geographical variations in prostate cancer outcomes: a systematic review of international evidence |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2019-04-01 |
description |
Background: Previous reviews of geographical disparities in the prostate cancer continuum from diagnosis to mortality have identified a consistent pattern of poorer outcomes with increasing residential disadvantage and for rural residents. However, there are no contemporary, systematic reviews summarizing the latest available evidence. Our objective was to systematically review the published international evidence for geographical variations in prostate cancer indicators by residential rurality and disadvantage.Methods: Systematic searches of peer-reviewed articles in English published from 1/1/1998 to 30/06/2018 using PubMed, EMBASE, CINAHL, and Informit databases. Inclusion criteria were: population was adult prostate cancer patients; outcome measure was PSA testing, prostate cancer incidence, stage at diagnosis, access to and use of services, survival, and prostate cancer mortality with quantitative results by residential rurality and/or disadvantage. Studies were critically appraised using a modified Newcastle-Ottawa Scale.Results: Overall 169 studies met the inclusion criteria. Around 50% were assessed as high quality and 50% moderate. Men from disadvantaged areas had consistently lower prostate-specific antigen (PSA) testing and prostate cancer incidence, poorer survival, more advanced disease and a trend toward higher mortality. Although less consistent, predominant patterns by rurality were lower PSA testing, prostate cancer incidence and survival, but higher stage disease and mortality among rural men. Both geographical measures were associated with variations in access and use of prostate cancer-related services for low to high risk disease.Conclusions: This review found substantial evidence that prostate cancer indicators varied by residential location across diverse populations and geographies. While wide variations in study design limited comparisons across studies, our review indicated that internationally, men living in disadvantaged areas, and to a lesser extent more rural areas, face a greater prostate cancer burden. This review highlights the need for a better understanding of the complex social, environmental, and behavioral reasons for these variations, recognizing that, while important, geographical access is not the only issue. Implementing research strategies to help identify these processes and to better understand the central role of disadvantage to variations in health outcome are crucial to inform the development of evidence-based targeted interventions. |
topic |
prostate cancer rural area-disadvantage health disparity systematic review geographical variations |
url |
https://www.frontiersin.org/article/10.3389/fonc.2019.00238/full |
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doaj-d79969a033614b109ca16955d44bd2702020-11-25T00:15:58ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2019-04-01910.3389/fonc.2019.00238423632Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International EvidenceParamita Dasgupta0Peter D. Baade1Peter D. Baade2Peter D. Baade3Joanne F. Aitken4Joanne F. Aitken5Joanne F. Aitken6Nicholas Ralph7Nicholas Ralph8Nicholas Ralph9Suzanne Kathleen Chambers10Suzanne Kathleen Chambers11Suzanne Kathleen Chambers12Suzanne Kathleen Chambers13Jeff Dunn14Jeff Dunn15Jeff Dunn16Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, AustraliaCancer Research Centre, Cancer Council Queensland, Brisbane, QLD, AustraliaMenzies Health Institute Queensland, Griffith University, Southport, QLD, AustraliaSchool of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, AustraliaCancer Research Centre, Cancer Council Queensland, Brisbane, QLD, AustraliaSchool of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, AustraliaInstitute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, AustraliaInstitute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, AustraliaSt Vincent's Private Hospital, Toowoomba, QLD, AustraliaSchool of Nursing & Midwifery, University of Southern Queensland, Toowoomba, QLD, AustraliaCancer Research Centre, Cancer Council Queensland, Brisbane, QLD, AustraliaMenzies Health Institute Queensland, Griffith University, Southport, QLD, AustraliaHealth and Wellness Institute, Edith Cowan University, Perth, WA, AustraliaFaculty of Health, University of Technology, Sydney, NSW, AustraliaCancer Research Centre, Cancer Council Queensland, Brisbane, QLD, AustraliaInstitute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, AustraliaFaculty of Health, University of Technology, Sydney, NSW, AustraliaBackground: Previous reviews of geographical disparities in the prostate cancer continuum from diagnosis to mortality have identified a consistent pattern of poorer outcomes with increasing residential disadvantage and for rural residents. However, there are no contemporary, systematic reviews summarizing the latest available evidence. Our objective was to systematically review the published international evidence for geographical variations in prostate cancer indicators by residential rurality and disadvantage.Methods: Systematic searches of peer-reviewed articles in English published from 1/1/1998 to 30/06/2018 using PubMed, EMBASE, CINAHL, and Informit databases. Inclusion criteria were: population was adult prostate cancer patients; outcome measure was PSA testing, prostate cancer incidence, stage at diagnosis, access to and use of services, survival, and prostate cancer mortality with quantitative results by residential rurality and/or disadvantage. Studies were critically appraised using a modified Newcastle-Ottawa Scale.Results: Overall 169 studies met the inclusion criteria. Around 50% were assessed as high quality and 50% moderate. Men from disadvantaged areas had consistently lower prostate-specific antigen (PSA) testing and prostate cancer incidence, poorer survival, more advanced disease and a trend toward higher mortality. Although less consistent, predominant patterns by rurality were lower PSA testing, prostate cancer incidence and survival, but higher stage disease and mortality among rural men. Both geographical measures were associated with variations in access and use of prostate cancer-related services for low to high risk disease.Conclusions: This review found substantial evidence that prostate cancer indicators varied by residential location across diverse populations and geographies. While wide variations in study design limited comparisons across studies, our review indicated that internationally, men living in disadvantaged areas, and to a lesser extent more rural areas, face a greater prostate cancer burden. This review highlights the need for a better understanding of the complex social, environmental, and behavioral reasons for these variations, recognizing that, while important, geographical access is not the only issue. Implementing research strategies to help identify these processes and to better understand the central role of disadvantage to variations in health outcome are crucial to inform the development of evidence-based targeted interventions.https://www.frontiersin.org/article/10.3389/fonc.2019.00238/fullprostate cancerruralarea-disadvantagehealth disparitysystematic reviewgeographical variations |