Mapping disadvantage: identifying inequities in functional outcomes for prostate cancer survivors based on geography.

Autor: Koo K; Radiation Oncology, Alfred Health, Melbourne, Australia. kendrick.koo@unimelb.edu.au.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. kendrick.koo@unimelb.edu.au.; Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria, Melbourne, Australia. kendrick.koo@unimelb.edu.au.; Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria, Australia. kendrick.koo@unimelb.edu.au., Papa N; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia., Evans M; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia., Jefford M; Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria, Australia.; Department of Health Services Research, Peter MacCallum Cancer Centre, Victoria, Melbourne, Australia., IJzerman M; Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria, Australia.; Centre for Cancer Research, Cancer Health Services Research, University of Melbourne, Victoria, Australia., White V; School of Psychology, Deakin University, Victoria, Australia.; Cancer Council Victoria, Melbourne, Australia., Evans SM; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.; Cancer Council Victoria, Melbourne, Australia., Ristevski E; Monash Rural Health - Warragul, Monash University, Victoria, Australia., Emery J; Centre for Cancer Research, Cancer Health Services Research, University of Melbourne, Victoria, Australia., Millar J; Radiation Oncology, Alfred Health, Melbourne, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Jazyk: angličtina
Zdroj: BMC cancer [BMC Cancer] 2022 Mar 17; Vol. 22 (1), pp. 283. Date of Electronic Publication: 2022 Mar 17.
DOI: 10.1186/s12885-022-09389-4
Abstrakt: Background: Prostate cancer is the most common internal malignancy in Australian men, and although most patients have good survival outcomes, treatment toxicities can impair function, leading to diminished quality of life for prostate cancer survivors. Socioeconomic disadvantage and geographical remoteness have been shown to be related to worse oncologic outcomes, and it is expected that they would similarly influence functional outcomes in prostate cancer.
Methods: Using data from the Victorian Prostate Cancer Outcomes Registry (n = 10,924), we investigated functional outcomes as measured by the Expanded Prostate Cancer Index Composite-26 (EPIC-26) following prostate cancer treatment, focusing on associations with socioeconomic status and geographical remoteness and controlling for clinicopathologic characteristics. A single composite score was developed from the five separate EPIC-26 domains for use in geo-mapping.
Results: A total of 7690 patients had complete EPIC-26 data, allowing mapping hotspots of poor function using our composite score. These hotspots were observed to relate to areas of socioeconomic disadvantage. Significant heterogeneity in outcomes was seen in urban areas, with hotspots of good and poor function. Both socioeconomic disadvantage and geographical remoteness were found to predict for worse functional outcomes, although only the former is significant on multivariate analysis.
Conclusions: Geo-mapping of functional outcomes in prostate cancer has the potential to guide health care service provision and planning. A nuanced policy approach is required so as not to miss disadvantaged patients who live in urban areas. We have demonstrated the potential of geo-mapping to visualise population-level outcomes, potentially allowing targeted interventions to address inequities in quality of care.
(© 2022. The Author(s).)
Databáze: MEDLINE
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