Rural-Urban Disparities in Colorectal Cancer Screening, Diagnosis, Treatment, and Survivorship Care: A Systematic Review and Meta-Analysis.

Autor:	Sepassi A; Department of Clinical Pharmacy Practice, University of California, Irvine School of Pharmacy & Pharmaceutical Sciences, Irvine, CA, USA., Li M; Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Zell JA; Division of Hematology/Oncology, University of California, Irvine School of Medicine, Irvine, CA, USA., Chan A; Department of Clinical Pharmacy Practice, University of California, Irvine School of Pharmacy & Pharmaceutical Sciences, Irvine, CA, USA., Saunders IM; Division of Clinical Pharmacy, University of California, San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences, La Jolla, CA, USA., Mukamel DB; Department of Medicine, University of California, Irvine, CA, USA.
Jazyk:	angličtina
Zdroj:	The oncologist [Oncologist] 2024 Apr 04; Vol. 29 (4), pp. e431-e446.
DOI:	10.1093/oncolo/oyad347
Abstrakt:	Background: Rural residents have a higher prevalence of colorectal cancer (CRC) mortality compared to urban individuals. Policies have been aimed at improving access to CRC screening to reduce these outcomes. However, little attention has been paid to other determinants of CRC-related outcomes, such as stage at diagnosis, treatment, or survivorship care. The main objective of this analysis was to evaluate literature describing differences in CRC screening, stage at diagnosis, treatment, and survivorship care between rural and urban individuals. Materials and Methods: We conducted a systematic review of electronic databases using a combination of MeSH and free-text search terms related to CRC screening, stage at diagnosis, treatment, survivorship care, and rurality. We identified 921 studies, of which 39 were included. We assessed methodological quality using the ROBINS-E tool and summarized findings descriptively. A meta-analysis was performed of studies evaluating CRC screening using a random-effects model. Results: Seventeen studies reported disparities between urban and rural populations in CRC screening, 12 on treatment disparities, and 8 on staging disparities. We found that rural individuals were significantly less likely to report any type of screening at any time period (pooled odds ratio = 0.81, 95% CI, 0.76-0.86). Results were inconclusive for disparities in staging at diagnosis and treatment. One study reported a lower likelihood of use of CRC survivorship care for rural individuals compared to urban individuals. Conclusion: There remains an urgent need to evaluate and address CRC disparities in rural areas. Investigators should focus future work on assessing the quality of staging at diagnosis, treatment, and survivorship care in rural areas. (© The Author(s) 2024. Published by Oxford University Press.)
Databáze:	MEDLINE
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