DataSheet_1_Factors associated with cancer survival disparities among Aboriginal and Torres Strait Islander peoples compared with other Australians: A systematic review.pdf

BackgroundWhile cancer survival among Aboriginal and Torres Strait Islander peoples has improved over time, they continue to experience poorer cancer survival than other Australians. Key drivers of these disparities are not well understood. This systematic review aimed to summarise existing evidence on Aboriginal and Torres Strait Islander cancer survival disparities and identify influential factors and potential solutions.MethodsIn accordance with PRISMA guidelines, multiple databases were systematically searched for English language peer-reviewed articles on cancer survival by Aboriginal and Torres Strait Islander status published from 1/1/2008 to 4/05/2022. Observational studies presenting adjusted survival measures in relation to potential causal factors for disparities were included. Articles were screened independently by two authors. Included studies were critically assessed using Joanna Briggs Institute tools.ResultsThirty population-based and predominantly state-level studies were included. A consistent pattern of poorer unadjusted cancer survival for Aboriginal and Torres Strait Islander peoples was evident. Studies varied widely in the covariates adjusted for including a combination of socio-demographics, cancer stage, comorbidities, and treatment. Potential contributions of these factors varied by cancer type. For lung and female breast cancer, adjusting for treatment and comorbidities reduced the survival disparity, which, while still elevated was no longer statistically significant. This pattern was also evident for cervical cancer after adjustment for stage and treatment. However, most studies for all cancers combined, or colorectal cancer, reported that unexplained survival disparities remained after adjusting for various combinations of covariates.ConclusionsWhile some of the poorer survival faced by Aboriginal and Torres Strait Islander cancer patients can be explained, substantial disparities likely to be related to Aboriginal determinants, remain. It is imperative that future research consider innovative study designs and strength-based approaches to better understand cancer survival for Aboriginal and Torres Strait Islander peoples and to inform evidence-based action.</p

ПОНЯТИЕ «ГОСУДАРСТВЕННАЯ СОСТОЯТЕЛЬНОСТЬ» В СОВРЕМЕННОЙ СОЦИАЛЬНО-ПОЛИТИЧЕСКОЙ НАУКЕ

<p>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.</p><p>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.</p><p>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.</p><p>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.</p

Maps of posterior probability (PP) for bowel cancer screening by Statistical Area Level 2 and time-period, persons, Australia., 2015–2016 with insets for selected major state and territory capitals.

Values of the PP for smoothed standardised participation ratios are truly lower than average (PP 0.8). The map for Canberra includes the boundary between the Australian Capital Territory and New South Wales. (TIF)</p

Estimated resident population (ERP) of persons aged 50–74 by Statistical Area Level 2 (SA2), Australia, 2016, with insets for selected major state and territory capitals.

The map for Canberra includes the boundary between the Australian Capital Territory and New South Wales. (TIF)</p

Estimated resident population (ERP) for each capital city, Australia, 2021.

Estimated resident population (ERP) for each capital city, Australia, 2021.</p

Maps of posterior probability (PP) for bowel cancer screening by Statistical Area Level 2 and time-period, persons, Australia., 2015–2016 with insets for selected major state and territory capitals.

Values of the PP for smoothed standardised participation ratios are truly lower than average (PP 0.8). The map for Canberra includes the boundary between the Australian Capital Territory and New South Wales. (TIF)</p

Maps of posterior probability (PP) for bowel cancer screening by Statistical Area Level 2 and time-period, persons, Australia., 2019–2020 with insets for selected major state and territory capitals.

Values of the PP for smoothed standardised participation ratios are truly lower than average (PP 0.8). The map for Canberra includes the boundary between the Australian Capital Territory and New South Wales.</p

Maps of the smoothed standardised participation ratios (sSPRs) for bowel cancer screening for persons by Statistical Area Level 2, 2015–2016, with insets of the state and territory capitals.

The map for Canberra includes the boundary between the Australian Capital Territory and New South Wales. An SPR with value 1 indicates that screening participation is the same as the national average (40.9%) during 2015–2016. (TIF)</p

Estimated smoothed standardised participation ratios (SPR), modelled counts and posterior probability (PP) that the smoothed SPR was greater than one, bowel cancer screening, Australia 2015–2020.

Estimated smoothed standardised participation ratios (SPR), modelled counts and posterior probability (PP) that the smoothed SPR was greater than one, bowel cancer screening, Australia 2015–2020.</p

Distribution of smoothed median standardised participation ratios (SPRs) by remoteness (A) socio-economic status (B), and state/territory (C), for bowel cancer screening, Australia 2019–2020.

The vertical line indicates an SPR of 1 representing the national average. Abbreviations are M.Adv Most advantaged, M.Disadv Most disadvantaged, NSW: New South Wales, WA: Western Australia, SA: South Australia, ACT: Australian Capital Territory, NT Northern Territory. (TIF)</p