Research in cancer care disparities in countries with universal healthcare: mapping the field and its conceptual contours

Sinding, Christina; Warren, Rachel; Fitzpatrick‐Lewis, Donna; Sussman, Jonathan

doi:10.1007/s00520-014-2348-3

Cited by 23 publications

(26 citation statements)

References 125 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings of worse cancer survival and lower rates of guideline recommended treatment for CRC patients with an SPI history are consistent with other studies [ 6 , 10 – 12 , 14 , 24 – 26 , 30 , 66 – 68 ]. Variation in the magnitude of effect between our study and others, as well as those finding no association may be the result of a number of methodological differences.…”

Section: Discussionsupporting

confidence: 93%

The effect of a severe psychiatric illness on colorectal cancer treatment and survival: A population-based retrospective cohort study

et al. 2020

View full text Add to dashboard Cite

Objectives To identify inequalities in cancer survival rates for patients with a history of severe psychiatric illness (SPI) compared to those with no history of mental illness and explore differences in the provision of recommended cancer treatment as a potential explanation. Design Population-based retrospective cohort study using linked cancer registry and administrative data at ICES. Setting The universal healthcare system in Ontario, Canada. Participants Colorectal cancer (CRC) patients diagnosed between April 1st, 2007 and December 31st, 2012. SPI history (schizophrenia, schizoaffective disorders, other psychotic disorders, bipolar disorders or major depressive disorders) was determined using hospitalization, emergency department, and psychiatrist visit data and categorized as ‘no history of mental illness, ‘outpatient SPI history’, and ‘inpatient SPI history’. Main outcome measures Cancer-specific survival, non-receipt of surgical resection, and non-receipt of adjuvant chemotherapy or radiation. Results 24,507 CRC patients were included; 482 (2.0%) had an outpatient SPI history and 258 (1.0%) had an inpatient SPI history. Individuals with an SPI history had significantly lower survival rates and were significantly less likely to receive guideline recommended treatment than CRC patients with no history of mental illness. The adjusted HR for cancer-specific death was 1.69 times higher for individuals with an inpatient SPI (95% CI 1.36–2.09) and 1.24 times higher for individuals with an outpatient SPI history (95% CI 1.04–1.48). Stage II and III CRC patients with an inpatient SPI history were 2.15 times less likely (95% CI 1.07–4.33) to receive potentially curative surgical resection and 2.07 times less likely (95% CI 1.72–2.50) to receive adjuvant radiation or chemotherapy. These findings were consistent across multiple sensitivity analyses. Conclusions Individuals with an SPI history experience inequalities in colorectal cancer care and survival within a universal healthcare system. Increasing advocacy and the availability of resources to support individuals with an SPI within the cancer system are warranted to reduce the potential for unnecessary harm.

show abstract

Section: Discussionsupporting

confidence: 93%

The effect of a severe psychiatric illness on colorectal cancer treatment and survival: A population-based retrospective cohort study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…We performed sensitivity analyses to explore potential sources of heterogeneity: (1) restricted to studies that defined advanced stage as the presence of metastasis at diagnosis, (2) restricted the analyses to population-based studies using similar methods of identifying mental disorders (eg, health services records), and (3) restricted to studies that did not include potential causal pathway variables. Potential causal pathway variables were determined from previous studies of cancer care disparities and included income, education, marital status and comorbidities 20 33–35. Analyses were completed using Review Manager (RevMan) version 5.3 36…”

Section: Methodsmentioning

confidence: 99%

Stage at diagnosis and survival in patients with cancer and a pre-existing mental illness: a meta-analysis

Davis

Bogner

Coburn

et al. 2019

J Epidemiol Community Health

View full text Add to dashboard Cite

IntroductionIndividuals with a pre-existing mental illness, especially those experiencing reduced social, occupational and functional capacity, are at risk for cancer care disparities. However, uncertainty surrounding the effect of a mental illness on cancer outcomes exists.MethodsWe conducted a systematic review and meta-analysis of observational studies using MEDLINE and PubMed from 1 January 2005 to 1 November 2018. Two reviewers evaluated citations for inclusion. Advanced stage was defined as regional, metastatic or according to a classification system. Cancer survival was defined as time survived from cancer diagnosis. Pooled ORs and HRs were presented. The Newcastle-Ottawa bias risk assessment scale was used. Random-effects models used the Mantel-Haenszel approach and the generic inverse variance method. Heterogeneity assessment was performed using I2.Results2381 citations were identified; 28 studies were included and 24 contributed to the meta-analysis. Many demonstrated methodological flaws, limiting interpretation and contributing to significant heterogeneity. Data source selection, definitions of a mental illness, outcomes and their measurement, and overadjustment for causal pathway variables influenced effect sizes. Pooled analyses suggested individuals with a pre-existing mental disorder have a higher odds of advanced stage cancer at diagnosis and are at risk of worse cancer survival. Individuals with more severe mental illness, such as schizophrenia, are at a greater risk for cancer disparities.DiscussionThis review identified critical gaps in research investigating cancer stage at diagnosis and survival for individuals with pre-existing mental illness. High-quality research is necessary to support quality improvement for the care of psychiatric patients and their families during and following a cancer diagnosis.

show abstract

“…Groups most vulnerable to these disparities are ones that experience discrimination and underlying levels of economic, social and geographic disadvantage 8. Cancer risk factors, screening rates, stage at diagnosis, receipt of guideline-recommended treatment, symptom management and cancer mortality vary by age, sex, immigration status, sexual orientation, socioeconomic position, geographic location, rurality and in indigenous populations 9–22. International, national and local cancer agencies have directed efforts to addressing barriers that lead to poorer outcomes and experiences for vulnerable populations 23–27.…”

Section: Introductionmentioning

confidence: 99%

Scoping review protocol documenting cancer outcomes and inequalities for adults living with intellectual and/or developmental disabilities

et al. 2019

View full text Add to dashboard Cite

IntroductionThere is increasing attention on the cancer burden for adults with intellectual and developmental disabilities (IDD). Emerging evidence suggests there are differences in cancer experiences and outcomes for individuals living with IDD, from risk through survivorship. These differences may be attributed to features of the IDD, such as cognitive deficits and communication, as well as social determinants of health-like lower education levels and ableism. However, there is no comprehensive overview of the literature quantifying these potential disparities and describing the influencing factors. In this paper, we describe a scoping review protocol to systematically review published literature on cancer for adults with IDD. The purpose of this review is to identify differences in cancer risk, stage at diagnosis, treatment and survival along the cancer continuum for adults with IDD and outline potential contributing factors creating these disparities.Methods and analysisWe will follow Arksey and O’Malley’s expanded framework for scoping reviews to conduct this review. We will systematically search electronic databases for peer-reviewed, published journal articles to identify appropriate studies in collaboration with a health science librarian. Two reviewers will independently review titles and abstracts followed by a full-text review to determine whether it meets inclusion criteria. A data chart for collecting and sorting information will be developed in consultation with the team. Results will be collated and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews: PRISMA-Scoping Reviews. Extracted information will be summarised quantitatively and qualitatively to meet review objectives.Ethics and disseminationThis scoping review will employ a methodology to identify literature related to cancer outcomes and experiences for adults with IDD. Results will be disseminated to relevant stakeholders who care for and support individuals with IDD at local, provincial and national levels and through publishing findings. By highlighting the disparities in the cancer system and gaps in the research, this scoping review can provide direction for future action.

show abstract

Research in cancer care disparities in countries with universal healthcare: mapping the field and its conceptual contours

Cited by 23 publications

References 125 publications

The effect of a severe psychiatric illness on colorectal cancer treatment and survival: A population-based retrospective cohort study

The effect of a severe psychiatric illness on colorectal cancer treatment and survival: A population-based retrospective cohort study

Stage at diagnosis and survival in patients with cancer and a pre-existing mental illness: a meta-analysis

Scoping review protocol documenting cancer outcomes and inequalities for adults living with intellectual and/or developmental disabilities

Contact Info

Product

Resources

About