Geographical variations in prostate cancer outcomes : A systematic review of international evidence
Journal article
Dasgupta, Paramita, Baade, Peter D., Aitken, Joanne F., Ralph, Nicholas, Chambers, Suzanne Kathleen and Dunn, Jeff. (2019). Geographical variations in prostate cancer outcomes : A systematic review of international evidence. Frontiers in Oncology. 9, p. Article 238. https://doi.org/10.3389/fonc.2019.00238
Authors | Dasgupta, Paramita, Baade, Peter D., Aitken, Joanne F., Ralph, Nicholas, Chambers, Suzanne Kathleen and Dunn, Jeff |
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Abstract | 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. |
Keywords | prostate cancer; rural; area-disadvantage; health disparity; systematic review; geographical variations; continuum of care |
Year | 2019 |
Journal | Frontiers in Oncology |
Journal citation | 9, p. Article 238 |
Publisher | Frontiers Research Foundation |
ISSN | 2234-943X |
Digital Object Identifier (DOI) | https://doi.org/10.3389/fonc.2019.00238 |
PubMed ID | 31024842 |
Scopus EID | 2-s2.0-85067560930 |
PubMed Central ID | PMC6463763 |
Open access | Published as ‘gold’ (paid) open access |
Research or scholarly | Research |
Page range | 1-35 |
Funder | National Health and Medical Research Council (NHMRC) |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 08 Apr 2019 |
Publication process dates | |
Accepted | 18 Mar 2019 |
Deposited | 16 Nov 2021 |
Grant ID | NHMRC/1098042 |
https://acuresearchbank.acu.edu.au/item/8x10y/geographical-variations-in-prostate-cancer-outcomes-a-systematic-review-of-international-evidence
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Publisher's version
OA_Dasgupta_2019_Geographical_variations_in_prostate_cancer_outcomes.pdf | |
License: CC BY 4.0 | |
File access level: Open |
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