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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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Autores principales: Dasgupta, Paramita, Baade, Peter D., Aitken, Joanne F., Ralph, Nicholas, Chambers, Suzanne Kathleen, Dunn, Jeff
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463763/
https://www.ncbi.nlm.nih.gov/pubmed/31024842
http://dx.doi.org/10.3389/fonc.2019.00238
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author Dasgupta, Paramita
Baade, Peter D.
Aitken, Joanne F.
Ralph, Nicholas
Chambers, Suzanne Kathleen
Dunn, Jeff
author_facet Dasgupta, Paramita
Baade, Peter D.
Aitken, Joanne F.
Ralph, Nicholas
Chambers, Suzanne Kathleen
Dunn, Jeff
author_sort Dasgupta, Paramita
collection PubMed
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.
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spelling pubmed-64637632019-04-25 Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence Dasgupta, Paramita Baade, Peter D. Aitken, Joanne F. Ralph, Nicholas Chambers, Suzanne Kathleen Dunn, Jeff Front Oncol Oncology 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. Frontiers Media S.A. 2019-04-08 /pmc/articles/PMC6463763/ /pubmed/31024842 http://dx.doi.org/10.3389/fonc.2019.00238 Text en Copyright © 2019 Dasgupta, Baade, Aitken, Ralph, Chambers and Dunn. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Dasgupta, Paramita
Baade, Peter D.
Aitken, Joanne F.
Ralph, Nicholas
Chambers, Suzanne Kathleen
Dunn, Jeff
Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence
title 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_short 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
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463763/
https://www.ncbi.nlm.nih.gov/pubmed/31024842
http://dx.doi.org/10.3389/fonc.2019.00238
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