Romi Carriere|Rosalind Adam|Shona Fielding|Raphae S. Barlas|Ariel Yuhan Ong|Peter Murchie
Rural dwellers are less likely to survive cancer – An international review and meta-analysis
University of Aberdeen|University of Aberdeen|University of Aberdeen|University of Aberdeen|Western General Hospital|University of Aberdeen
existing research several countries suggested ruraldwellers may poorer cancer survival urbandwellers however date global literature systematically reviewed determine whether rural cancer survival disadvantage global phenomenonmedline cinahl embase searched studies comparing rural urban cancer survival least two authors independently screened selected studies included epidemiological studies comparing cancer survival urban rural residents however defined also took socioeconomic status account metaanalysis conducted using 11 studies binary ruralurban classifications determine magnitude direction association rurality differences cancer survival mechanisms urbanrural cancer survival differences reported narratively synthesised 39 studies39 studies included review retrospective observational studies conducted developed countries ruraldwellers significantly likely die developed cancer compared urbandwellers hr 105 95 ci 102 107 potential mechanisms aggregated ecological model following themes patient level characteristics institutions community culture environment policy service organizationrural residents 5 less likely survive cancer effect consistently observed across studies conducted various geographical regions using multiple definitions rurality high quality mixedmethods research required comprehensively evaluate underlying factors proposed ecological model provide coherent framework future explanatory researchnone