A systematic review of inequalities in psychosocial outcomes for women with breast cancer according to residential location and Indigenous status in Australia

Abstract

Background: The aim of this systematic review was to examine variations in psychosocial outcomes by residential location and Indigenous status in women diagnosed with breast cancer (BC) in Australia.Methods: Systematic searches were undertaken using multiple databases covering articles between 1 January 1990 and 1 March 2015 focusing on adult women with BC in an Australian setting and measuring quality of life (QOL), psychological distress or psychosocial support.Results: Thirteen quantitative and three qualitative articles were included. Two quantitative and one qualitative article were rated high quality, seven moderate and the remaining were low quality. No studies examining inequalities by Indigenous status were identified. Non-metropolitan women were more likely to record lower QOL relating to breast cancer-specific concerns and reported a lack of information and resources specific to their needs. Continuity of support, ongoing care and access to specialist and allied health professionals were major concerns for non-metropolitan women. Nonmetropolitan women identified unmet needs in relation to travel, fear of cancer recurrence and lack of psychosocial support.Conclusions: Overall, there was a lack of evidence relating to variations in psychosocial outcomes for women with BC according to residential status or Indigenous status. While the review identified some specific concerns for non-metropolitan women with BC, it was limited by the lack of good quality studies using standardised measures.

Factors influencing breast cancer outcomes in Australia: A systematic review

“…These characteristics were reflected in another review which explored the psychosocial outcomes for women with breast cancer. It showed that geographically isolated women had less access to information, services and continuity of care (Youl et al, ). The last review found some evidence towards greater survival for women with higher socioeconomic status; however, this was not conclusive (Lyle et al, ).…”

“…There are several accepted factors which increase breast cancer recurrence and mortality which can be categorised into patient, tumour and treatment characteristics (Adami, Malker, Holmberg, Persson, & Stone, 1986;Carter, Allen, & Henson, 1989;Dasgupta et al, 2017;Fisher, Slack, & Bross, 1969;Joensuu et al, 2004;Koscielny et al, 1984;Li, Uribe, & Daling, 2005;Newman, 2009;Siegel, Miller, & Jemal, 2017;Tapia et al, 2017). These characteristics include patient age, ethnicity, tumour type, size, grade, stage, hormone receptor status, type of surgery and use of adjuvant therapies (Adami et al, 1986;Anders et al, 2008;Carter et al, 1989;Dasgupta et al, 2017;Fisher et al, 1969;Joensuu et al, 2004;Koscielny et al, 1984;Li et al, 2005;Newman, 2009;Siegel et al, 2017;Tapia et al, 2017;Youl et al, 2016).…”

Development and validation of a search filter to identify equity-focused studies: reducing the number needed to screen

“…no. reviews contributing termsReviews contributing terms‘Place’Place of residence5No-5No-5[10–14]‘Race’Race / ethnicity / culture / language3Yes →69No-9[11, 15–22]Occupation6No-6No-6[11], [13], [16], [23], [24], [25]‘Gender’Gender / sex1Yes →67No-7[16], [17], [18], [19], [26], [27], [28]Religion0Yes →11Yes →23[17, 29, 30]Education7No-7No-7[11, 13, 16, 24, 25, 31, 32]‘SES’Socio-economic status12No-12No-12[11], [13], [15], [23], [24], [25], [31], [32], [33], [34], [35], [36]Social capital0Yes →11Yes →45[17, 37–40]Other category not encompassed by PROGRESS-Plus6No-...…”

Unmet supportive care needs among people with cancer: A cross‐cultural comparison between Indigenous and Non‐Indigenous Australians

“…In 2017, it was estimated that 134,174 new cases would be diagnosed in Australia that will eventually lead to premature death and disability (Au et al, 2011;Australian Institute of Health & Welfare, 2017;Youl et al, 2016;Zucca, Boyes, Newling, Hall, & Girgis, 2011). In 2017, it was estimated that 134,174 new cases would be diagnosed in Australia that will eventually lead to premature death and disability (Au et al, 2011;Australian Institute of Health & Welfare, 2017;Youl et al, 2016;Zucca, Boyes, Newling, Hall, & Girgis, 2011).…”

“…This assessment provides a direct measurement of the persons own perceptions of their need for help as well as the magnitude of their desire for help with those needs (Boyes, Girgis, & Lecathelinais, 2009). Cross-cultural and international comparisons of unmet supportive care needs have shown that different groups tend to prioritise different domains, for example, Japanese (Akechi et al, 2011) and Caucasian (Youl et al, 2016) women with breast cancer prioritise psychological needs while Chinese (Au et al, 2011) women prioritise information regarding health systems. Cross-cultural and international comparisons of unmet supportive care needs have shown that different groups tend to prioritise different domains, for example, Japanese (Akechi et al, 2011) and Caucasian (Youl et al, 2016) women with breast cancer prioritise psychological needs while Chinese (Au et al, 2011) women prioritise information regarding health systems.…”