Geographical variations in the clinical management of colorectal cancer in Australia: a systematic review

Crawford-Williams, Fiona and March, Sonja and Ireland, Michael J. and Rowe, Arlen and Goodwin, Belinda and Hyde, Melissa K. and Chambers, Suzanne K. and Aitken, Joanne F. and Dunn, Jeff (2018) Geographical variations in the clinical management of colorectal cancer in Australia: a systematic review. Frontiers in Oncology, 8 (116). pp. 1-10. ISSN 2234-943X

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Abstract

Background: In Australia, cancer survival is significantly lower in non-metropolitan compared to metropolitan areas. Our objective was to evaluate the evidence on geographical variations in the clinical management and treatment of colorectal cancer (CRC).

Methods: A systematic review of published and gray literature was conducted. Five databases (CINAHL, PubMed, Embase, ProQuest, and Informit) were searched for articles published in English from 1990 to 2018. Studies were included if they assessed differences in clinical management according to geographical location; focused on CRC patients; and were conducted in Australia. Included studies were critically appraised using a modified Newcastle–Ottawa Scale. PRISMA systematic review reporting methods were applied.

Results: 17 articles met inclusion criteria. All were of high (53%) or moderate (47%) quality. The evidence available may suggest that patients in non-metropolitan areas are more likely to experience delays in surgery and are less likely to receive chemotherapy for stage III colon cancer and adjuvant radiotherapy for rectal cancer.

Conclusion: The present review found limited information on clinical management across geographic regions in Australia and the synthesis highlights significant issues both for data collection and reporting at the population level, and for future research in the area of geographic variation. Where geographical disparities exist, these may be due to a combination of patient and system factors reflective of location. It is recommended that population-level data regarding clinical management of CRC be routinely collected to better understand geographical variations and inform future guidelines and policy.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Copyright © 2018 Crawford-Williams, March, Ireland, Rowe, Goodwin, Hyde, Chambers, Aitken and Dunn. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Faculty / Department / School: Current - Institute for Resilient Regions
Date Deposited: 18 Jul 2018 06:25
Last Modified: 19 Jul 2018 04:52
Uncontrolled Keywords: colorectal cancer; rural health; health disparity; cancer treatment; systematic review
Fields of Research : 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified
17 Psychology and Cognitive Sciences > 1701 Psychology > 170113 Social and Community Psychology
11 Medical and Health Sciences > 1112 Oncology and Carcinogenesis > 111299 Oncology and Carcinogenesis not elsewhere classified
Socio-Economic Objective: C Society > 92 Health > 9202 Health and Support Services > 920299 Health and Support Services not elsewhere classified
Identification Number or DOI: 10.3389/fonc.2018.00116
URI: http://eprints.usq.edu.au/id/eprint/34511

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