Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence

摘要: Background: Previous reviews of geographical disparities in the prostate cancer continuum from diagnosis to mortality have identified a consistent pattern poorer outcomes with increasing residential disadvantage and for rural residents. However, there are no contemporary, systematic summarizing latest available evidence. Our objective was systematically review published international evidence variations indicators by rurality disadvantage. Methods: Systematic searches peer-reviewed articles English 1/1/1998 30/06/2018 using PubMed, EMBASE, CINAHL, Informit databases. Inclusion criteria were: population adult patients; outcome measure PSA testing, incidence, stage at diagnosis, access use services, survival, quantitative results and/or Studies were critically appraised modified Newcastle-Ottawa Scale. Results: Overall 169 studies met inclusion criteria. Around 50% assessed as high quality moderate. Men disadvantaged areas had consistently lower prostate-specific antigen (PSA) testing more advanced disease trend toward higher mortality. Although less consistent, predominant patterns incidence but among men. Both measures associated cancer-related services low risk disease. Conclusions: This found substantial that varied location across diverse populations geographies. While wide study design limited comparisons studies, our indicated internationally, men living areas, lesser extent face greater burden. highlights need better understanding complex social, environmental, behavioral reasons these variations, recognizing that, while important, is not only issue. Implementing research strategies help identify processes understand central role health crucial inform development evidence-based targeted interventions.