A systematic review of geographical differences in management and outcomes for colorectal cancer in Australia

Ireland, Michael; March, Sonja; Crawford‐Williams, Fiona; Cassimatis, Mandy; Aitken, Joanne F.; Hyde, Melissa K.; Chambers, Suzanne K.; Sun, Jiandong; Dunn, Jeff

doi:10.1186/s12885-017-3067-1

Cited by 43 publications

(46 citation statements)

References 53 publications

(46 reference statements)

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“…A systematic review of differences by place of residence in clinical management and outcomes for colorectal cancer patients in Australia found worse survival for patients who lived outside major cities . Some of the reviewed factors appeared to explain part of the observed differences in survival.…”

Section: Discussionmentioning

confidence: 99%

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Rural–urban residence and cancer survival in high‐income countries: A systematic review

Afshar

English

Milne

2019

Cancer

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There is some evidence that place of residence is associated with cancer survival, but the findings are inconsistent, and the underlying mechanisms by which residential location might affect survival are not well understood. We conducted a systematic review of observational studies investigating the association of rural versus urban residence with cancer survival in high‐income countries. We searched the Ovid Medline, EMBASE, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases up to May 31, 2016. Forty‐five studies published between 1984 and 2016 were included. We extracted unadjusted and adjusted relative risk estimates with the corresponding 95% confidence intervals. Most studies reported worse survival for cancer patients living in rural areas than those in urban regions. The most consistent evidence, observed across several studies, was for colorectal, lung, and prostate cancer. Of the included studies, 18 did not account for socio‐economic position. Lower survival for more disadvantaged patients is well documented; therefore, it could be beneficial for future research to take socio‐economic factors into consideration when assessing rural/urban differences in cancer survival. Some studies cited differential stage at diagnosis and treatment modalities as major contributing factors to regional inequalities in cancer survival. Further research is needed to disentangle the mediating effects of these factors, which may help to establish effective interventions to improve survival for patients living outside major cities.

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Section: Discussionmentioning

confidence: 99%

“…The World Bank Data 2014 was used to identify high‐income nations . We expanded our search by reviewing the bibliographies of all eligible studies and related reviews . We also conducted a search using Google Scholar to identify potentially eligible studies that might not have been detected through the above process.…”

Section: Methodsmentioning

confidence: 99%

Rural–urban residence and cancer survival in high‐income countries: A systematic review

Afshar

English

Milne

2019

Cancer

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“…Among patients with metastatic CRC, median survival in Greenland was similar to patients in Scandinavia: 17 vs. 15.8 months for patients treated with chemotherapy and 2 vs. 2.8 months for patients receiving best supportive care alone [20]. Despite a previous study in Greenland suggesting a significant diagnostic delay for patients living in remote areas outside Nuuk [6], and international research reporting on significant disparities in cancer-related outcomes in rural and remote areas [10–13], we found no significant difference in stage distribution or survival rates between patients from Nuuk and patients living along the coastline outside Nuuk.…”

Section: Discussionmentioning

confidence: 99%

“…Data from a recent study in Greenland evaluating 113 CRC patients indicated that patients living on the coastline were exposed to a significant diagnostic delay compared to their counterparts in Nuuk [9]. Geographical remoteness has also been shown to cause disparities in treatment patterns and outcome for cancer patients living in Australia, USA and Canada [10–13]. Globally, survival is generally better in countries with good access to specialised care [14].…”

Section: Introductionmentioning

confidence: 99%

Oncological treatment and outcome of colorectal cancer in Greenland

Odgaard

Lohse

Petersen

et al. 2018

International Journal of Circumpolar Health

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Oncological treatment of colorectal cancer (CRC) has been available in Greenland since 2004. Treatment is provided by Queen Ingrid´s Hospital (QIH), under supervision from the Department of Oncology, Rigshospitalet, Denmark. The study describes patient characteristics, oncological treatment and survival for the first 8 years of treatment. The study was a registry-based observational study of all patients in Greenland diagnosed with histologically verified CRC from August 2004 to August 2012. Analyses were stratified according to stage and discussed in relation to reported data from patients with CRC in Denmark. 180 patients were included. . Stage I, II, III, and IV comprised 15, 34, 23, and 23%, respectively. 5% presented with unknown stage. A total of 51% received oncological treatment. 79% of patients with Stage III disease received adjuvant chemotherapy, 61% of patients with metastatic CRC received palliative chemotherapy. Five-year survival was 48 and 53% for colon and rectum cancer, respectively. An insignificant trend towards higher survival in men than in women was seen; adjusted hazard ratio for death (women vs men) = 1.46 (95% CI = 0.97–2.19). In conclusion; Stage distribution, provision of oncological treatment and 5-year survival were comparable to patients diagnosed and treated in Denmark.

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“…Colorectal cancer (CRC) or bowel cancer is the most common cancer for men and women combined and is the second leading cause of cancer death in Australia 5 . Our systematic review showed that people with CRC living in non‐metropolitan Australia have poorer survival rates compared to those living in metropolitan areas 6 . Although this may be due to an interplay of numerous personal, community and health system influences, evidence suggests early detection may play an important role 7,8 .…”

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confidence: 86%

Socio‐demographic factors drive regional differences in participation in the National Bowel Cancer Screening Program – An ecological analysis

Sun

March

Ireland

et al. 2018

Australian and New Zealand Journal of Public Health

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A ustralia performs exceptionally well in improving the overall survival of people diagnosed with cancer. 1 However, advances in early detection and treatment of cancer may not benefit all Australians equally. Significant disparities in health outcomes -including cancer mortality -continue to exist, most notably among people living in rural, regional and remote areas of Australia and Indigenous Australians. 2-4Colorectal cancer (CRC) or bowel cancer is the most common cancer for men and women combined and is the second leading cause of cancer death in Australia. 5 This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Aust NZ J Public Health. 2018; 42:92-7; doi: 10.1111/1753 Abstract Objective: To examine if geographic variations in the participation rates in the National Bowel Cancer Screening Program (NBCSP) are related to population-level socio-demographic characteristics.Methods: Data reflecting participation in the NBCSP for 504 Local Government Areas (LGAs) between July 2011 and June 2013 were extracted from the Social Health Atlas of Australia. Logistic regression models were used to examine independent associations (odds ratios [ORs]) between participation, Remoteness Area (RA) and selected socio-demographic variables.Results: Compared to the participation rate for major cities (33.4%), participation was significantly higher in inner regional areas (36.5%, OR=1.15), but was much lower in remote (27.9%, OR=0.77) or very remote areas (25.0%, OR=0.65). When controlling for study period, gender, proportion of persons aged 65 years and older, Indigenous status, cultural background and socioeconomic status, significantly higher rates were observed in all non-metropolitan areas than in major cities. Indigenous status was strongly related to the poorer participation in remote areas.Conclusions: Socio-demographic characteristics, particularly Indigenous status, cultural background and population ageing, seem to be more important drivers of regional disparities in NBCSP participation than geographic remoteness. Implications for public health:This study provides important evidence to understand the regional disparities in participating in the national screening program.

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A systematic review of geographical differences in management and outcomes for colorectal cancer in Australia

Cited by 43 publications

References 53 publications

Rural–urban residence and cancer survival in high‐income countries: A systematic review

Rural–urban residence and cancer survival in high‐income countries: A systematic review

Oncological treatment and outcome of colorectal cancer in Greenland

Socio‐demographic factors drive regional differences in participation in the National Bowel Cancer Screening Program – An ecological analysis

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