Geographical variations in the clinical management of colorectal cancer in Australia : A systematic review
Crawford-Williams, Fiona, March, Sonja, Ireland, Michael J., Rowe, Arlen, Goodwin, Belinda, Hyde, Melissa K., Chambers, Suzanne K., Aitken, Joanne F. and Dunn, Jeff. (2018). Geographical variations in the clinical management of colorectal cancer in Australia : A systematic review. Frontiers in Oncology. 8, p. Article 116. https://doi.org/10.3389/fonc.2018.00116
|Authors||Crawford-Williams, Fiona, March, Sonja, Ireland, Michael J., Rowe, Arlen, Goodwin, Belinda, Hyde, Melissa K., Chambers, Suzanne K., Aitken, Joanne F. and Dunn, Jeff|
Background: In Australia, cancer survival is significantly lower in non-metropolitan compared to metropolitan areas. Our objective was to evaluate the evidence on geographical variations in the clinical management and treatment of colorectal cancer (CRC).
Methods: A systematic review of published and gray literature was conducted. Five databases (CINAHL, PubMed, Embase, ProQuest, and Informit) were searched for articles published in English from 1990 to 2018. Studies were included if they assessed differences in clinical management according to geographical location; focused on CRC patients; and were conducted in Australia. Included studies were critically appraised using a modified Newcastle–Ottawa Scale. PRISMA systematic review reporting methods were applied.
Results: 17 articles met inclusion criteria. All were of high (53%) or moderate (47%) quality. The evidence available may suggest that patients in non-metropolitan areas are more likely to experience delays in surgery and are less likely to receive chemotherapy for stage III colon cancer and adjuvant radiotherapy for rectal cancer.
Conclusion: The present review found limited information on clinical management across geographic regions in Australia and the synthesis highlights significant issues both for data collection and reporting at the population level, and for future research in the area of geographic variation. Where geographical disparities exist, these may be due to a combination of patient and system factors reflective of location. It is recommended that population-level data regarding clinical management of CRC be routinely collected to better understand geographical variations and inform future guidelines and policy.
|Keywords||colorectal cancer; rural health; health disparity; cancer treatment; systematic review|
|Journal||Frontiers in Oncology|
|Journal citation||8, p. Article 116|
|Publisher||Frontiers Research Foundation|
|Digital Object Identifier (DOI)||https://doi.org/10.3389/fonc.2018.00116|
|PubMed Central ID||PMC5965390|
|Open access||Published as ‘gold’ (paid) open access|
|Research or scholarly||Research|
File Access Level
|Online||16 May 2018|
|Publication process dates|
|Accepted||29 Mar 2018|
|Deposited||16 Nov 2021|
|License: CC BY 4.0|
|File access level: Open|
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