Geographical Factors Associated with Health Disparities in Prostate Cancer

Gilbert, Scott M.; Pow‐Sang, Julio M.; Xiao, Hong

doi:10.1177/107327481602300411

Cited by 17 publications

(10 citation statements)

References 60 publications

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“…Our findings were consistent with two earlier systematic reviews on variations in prostate cancer incidence and mortality by rurality (5) and survival by socioeconomic disadvantage (7), respectively. Two earlier reviews also found persistent geographical disparities across a range of prostate cancer outcomes in the USA (201) and worldwide (4). None of these previous reviews critically assessed studies or included the one-third (58 of 169) of articles included in this review published since 2014.…”

Section: Discussionmentioning

confidence: 92%

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

et al. 2019

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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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Section: Discussionmentioning

confidence: 92%

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

et al. 2019

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“…However, as noted in previous studies socioeconomic status and educational level have been found to negatively impact prostate cancer screening and overall cancer outcomes. 1,8,9,30 …”

Section: Discussionmentioning

confidence: 99%

“…Being AA, older, and having a positive family history of PCa are all associated with increased risk of a PCa diagnosis and death. 7–8 Beyond these risk factors, Gilbert et al 8 concluded that men of lower social status and educational level were also less likely to participate in PCa screening.…”

Section: Prostate Cancermentioning

confidence: 99%

A pilot study of prostate cancer knowledge among African American men and their health care advocates: implications for screening decisions

Oliver

Allen

Eichorst

et al. 2018

Cancer Causes Control

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Health care advocates of the 33 male participants were usually women, spouses, or significant others, supporting the vital role women play in men's health specifically in rural underserved communities. Low overall PCa knowledge, including their risk for PCa, among these participants indicates a need for PCa and screening educational interventions and dialogue that include males and their significant others.

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“…However, certain geographic variations in quality of care linked to racial disparities are still undeniable. 3 In addition, Kaur et al most recently warned that improvements in survival disparities in the prostate-specific antigen era might be smaller than observed as they affect both African American and white American men equally. 4 Such "artifacts of screening" need to be taken into account when interpreting current prostate cancer survival data.…”

Section: Editorial Commentmentioning

confidence: 99%

“…In summary, these observations show a shift from the generally accepted paradigm of worse prostate cancer survival in African American men. However, certain geographic variations in quality of care linked to racial disparities are still undeniable . In addition, Kaur et al .…”

mentioning

confidence: 99%

Editorial Comment to Racial disparities in lymph node dissection at radical prostatectomy: A Surveillance, Epidemiology and End Results database analysis

Schmid

Meyer

2018

Int J of Urology

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Geographical Factors Associated with Health Disparities in Prostate Cancer

Cited by 17 publications

References 60 publications

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

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

A pilot study of prostate cancer knowledge among African American men and their health care advocates: implications for screening decisions

Editorial Comment to Racial disparities in lymph node dissection at radical prostatectomy: A Surveillance, Epidemiology and End Results database analysis

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