Where are the inequalities in colorectal cancer care in a country with universal healthcare? A systematic review and narrative synthesis

Pickwell-Smith, Benjamin Alexander; Spencer, Katie; Sadeghi, Mahboobeh Haji; Greenley, Sarah; Lind, Michael; Macleod, Una

doi:10.1136/bmjopen-2023-080467

Cited by 3 publications

(1 citation statement)

References 64 publications

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“…Extensive research has highlighted the profound impact of socio-economic status, gender, and education on survival rates across a spectrum of medical conditions, including cancer and AIDS [2]. These studies reveal persistent disparities in survivability, even in countries with universal health coverage like England [3] and Australia [4] with universal health coverage. This study endeavors to bridge this gap by exploring the complex relationship between demographic indicators and survival rates for diverse diseases.…”

Section: Unveiling the Impact Of Demographic Factors On Disease Survi...mentioning

confidence: 99%

Unveiling the Impact of Demographic Factors on Disease Survival: A Multifaceted Examination across Diverse Medical Conditions

Cherukuri,

Rajput,

Neema

2024

IJHS

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Purpose: In this research, we studied the intricate interplay between demographic indicators and survival rates across various diseases, aiming to address the gap in comprehensive analyses across multiple conditions. Methodology: Drawing from a dataset encompassing 9105 critically ill patients from five medical centers in the United States [1], admitted between1989-1991 and 1992-1994, our analysis spans eight disease categories. Leveraging techniques such as Cox-proportional hazard models and machine learning algorithms, we explore the influence of socio-economic status, gender, race, and education on survival outcomes. Findings: Our findings underscore significant demographic disparities in disease survivability, with ethnicity, gender, and education level showing varying impacts across different medical conditions. Notably, Asians exhibit lower hazards for certain diseases but higher hazards for others, while females demonstrate better survival probabilities compared to males. Moreover, individuals with higher education levels tend to have slightly increased hazards for certain conditions. Unique Contribution to Theory, Practice, and Policy: The call for comparative analyses across multiple diseases using comprehensive datasets marks a pivotal shift in research strategy. It aims to highlight the interplays and shared risk factors across diseases, contributing significantly to the advancement of theoretical frameworks, the refinement of healthcare practices, and the shaping of informed public health policies. This approach seeks to bridge a critical gap in the literature, offering a foundation for interventions designed to enhance disease management and improve population health outcomes comprehensively.

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Section: Unveiling the Impact Of Demographic Factors On Disease Survi...mentioning

confidence: 99%

Unveiling the Impact of Demographic Factors on Disease Survival: A Multifaceted Examination across Diverse Medical Conditions

Cherukuri,

Rajput,

Neema

2024

IJHS

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Artificial intelligence in colorectal multidisciplinary team meetings. What are the medicolegal implications?

Tjhin,

Kewlani,

Singh

et al. 2024

Colorectal Disease

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AimTo give an insight into areas for future development and suggestions in the complexities of incorporation of AI into human colorectal cancer (CRC) care while bringing into focus the importance of clinicians' roles in patient care.MethodsExisting literature around AI use in CRC care is reviewed and potential regulatory issues and medicolegal implications around its implementation in CRC multidisciplinary team meetings (MDTs) are identified.ResultsChallenges with patient privacy and confidentiality, patient consent, inequity and bias, patient autonomy, as well as AI system transparency and the liability and accountability issues arising from complications that arise from AI‐aided clinical decisions are important focusses associated with the use of AI in CRC MDTs.ConclusionConsideration of various medicolegal aspects of the use of AI in CRC MDTs is warranted to ensure its safe and smooth incorporation into CRC MDTs. AI function as a clinical decision support system and does not replace professional expertise.

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Undiagnosed type 2 diabetes is common – intensified screening of established risk groups is imperative in Sweden: the SDPP cohort

Gudjonsdottir,

Tynelius,

Stattin

et al. 2024

BMC Med

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Background Undiagnosed type 2 diabetes (T2D) is a global problem. Current strategies for diagnosis in Sweden include screening individuals within primary healthcare who are of high risk, such as those with hypertension, obesity, prediabetes, family history of diabetes, or those who smoke daily. In this study, we aimed to estimate the proportion of individuals with undiagnosed T2D in Stockholm County and factors associated with T2D being diagnosed by healthcare. This information could improve strategies for detection. Methods We used data from the Stockholm Diabetes Prevention Programme (SDPP) cohort together with information from national and regional registers. Individuals without T2D aged 35–56 years at baseline were followed up after two ten-year periods. The proportion of diagnosed T2D was based on register information for 7664 individuals during period 1 and for 5148 during period 2. Undiagnosed T2D was assessed by oral glucose tolerance tests at the end of each period. With logistic regression, we analysed factors associated with being diagnosed among individuals with T2D. Results At the end of the first period, the proportion of individuals with T2D who had been diagnosed with T2D or not was similar (54.0% undiagnosed). At the end of the second period, the proportion of individuals with T2D was generally higher, but they were less likely to be undiagnosed (43.5%). The likelihood of being diagnosed was in adjusted analyses associated with overweight (OR=1.85; 95% CI 1.22–2.80), obesity (OR=2.73; 95% CI 1.76–4.23), higher fasting blood glucose (OR=2.11; 95% CI 1.67–2.66), and self-estimated poor general health (OR=2.42; 95% CI 1.07–5.45). Socioeconomic factors were not associated with being diagnosed among individuals with T2D. Most individuals (>71%) who developed T2D belonged to risk groups defined by having at least two of the prominent risk factors obesity, hypertension, daily smoking, prediabetes, or family history of T2D, including individuals with T2D who had not been diagnosed by healthcare. Conclusions Nearly half of individuals who develop T2D during 10 years in Stockholm County are undiagnosed, emphasizing a need for intensified screening of T2D within primary healthcare. Screening can be targeted to individuals who have at least two prominent risk factors.

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Where are the inequalities in colorectal cancer care in a country with universal healthcare? A systematic review and narrative synthesis

Cited by 3 publications

References 64 publications

Unveiling the Impact of Demographic Factors on Disease Survival: A Multifaceted Examination across Diverse Medical Conditions

Unveiling the Impact of Demographic Factors on Disease Survival: A Multifaceted Examination across Diverse Medical Conditions

Artificial intelligence in colorectal multidisciplinary team meetings. What are the medicolegal implications?

Undiagnosed type 2 diabetes is common – intensified screening of established risk groups is imperative in Sweden: the SDPP cohort

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