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Title: Geographic disparities in prostate cancer outcomes--review of international patterns
Authors: Baade PD; Yu XQ; Smith DP; Dunn J; Chambers SK
Categories: Cancer Type - Prostate Cancer
Etiology - Exogenous Factors in the Origin and Cause of Cancer
Year: 2015
Journal Title: Asian Pacific Journal of Cancer Prevention
Volume: 16
Issue: 3
Page number start: 1259
Page number end: 1275
Abstract: BACKGROUND: This study reviewed the published evidence as to how prostate cancer outcomes vary across geographical remoteness and area level disadvantage. MATERIALS AND METHODS: A review of the literature published from January 1998 to January 2014 was undertaken: Medline and CINAHL databases were searched in February to May 2014. The search terms included terms of 'Prostate cancer' and 'prostatic neoplasms' coupled with 'rural health', 'urban health', 'geographic inequalities', 'spatial', 'socioeconomic', 'disadvantage', 'health literacy' or 'health service accessibility'. Outcome specific terms were 'incidence', 'mortality', 'prevalence', 'survival', 'disease progression', 'PSA testing' or 'PSA screening', 'treatment', 'treatment complications' and 'recurrence'. A further search through internet search engines was conducted to identify any additional relevant published reports. RESULTS: 91 papers were included in the review. While patterns were sometimes contrasting, the predominate patterns were for PSA testing to be more common in urban (5 studies out of 6) and affluent areas (2 of 2), higher prostate cancer incidence in urban (12 of 22) and affluent (18 of 20), greater risk of advanced stage prostate cancer in rural (7 of 11) and disadvantaged (8 of 9), higher survival in urban (8 of 13) and affluent (16 of 18), greater access or use of definitive treatment services in urban (6 of 9) and affluent (7 of 7), and higher prostate mortality in rural (10 of 20) and disadvantaged (8 of 16) areas. CONCLUSIONS: Future studies may need to utilise a mixed methods approach, in which the quantifiable attributes of the individuals living within areas are measured along with the characteristics of the areas themselves, but importantly include a qualitative examination of the lived experience of people within those areas. These studies should be conducted across a range of international countries using consistent measures and incorporate dialogue between clinicians, epidemiologists, policy advocates and disease control specialists.
Division: Cancer Research Division
Funding Body: Prostate Cancer Foundation of Australia (PCFA).
Australian National Health and Medical Research Council
Australian Research Council Future Fellowship
Grant ID: Career Development Fellowship (1005334) Peter Baade
(FT120100366) Suzanne Chambers
Early Career Fellowship (1016598) David Smith
DOI: 10.7314/APJCP.2015.16.3.1259
Appears in Collections:Research Articles

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