Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Is health-related quality of life in rural cancer survivors better or worse than in urban survivors? A systematic review. (#265)

Eli Ristevski 1 , Sarah Latham 2 , Victoria White 3 , Kate Webber 4 5 , Colin Wood 6 , Karolina Lisy 6 7 8 , Nikki Davis 9 , Colin O'Brien 9 , Michael Jefford 6 7 8
  1. Monash University, Monash Rural Health, Warragul, Victoria, Australia
  2. Medical Oncology, Alfred Health, Melbourne, Victoria, Australia
  3. Deakin University, School of Psychology, Melbourne, Burwood, Victoria, Australia
  4. Medical Oncology, Monash Health, Melbourne, Victoria, Australia
  5. School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
  6. Department of Health Services Research, Peter MacCallum Cancer Centre,, Melbourne, Victoria, Australia
  7. Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre,, Melbourne, Victoria, Australia
  8. Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
  9. Cancer Advocate, Melbourne, Victoria, Australia

Background: While there is evidence of inferior cancer survival outcomes for people in rural areas, there is no systematic evidence whether health-related quality of life (HRQOL) is lower in rural cancer survivors (RCS) than urban cancer survivors (UCS). We conducted a systematic review to describe HRQOL outcomes in RCS and compared outcomes with urban UCS. Methods: We searched Medline, Embase, CINAHL and PsycINFO (2000-2022) for studies with adults in rural/regional/remote areas who had completed definitive primary cancer treatment and were no longer receiving anticancer therapy. Studies with and without an urban comparator and using a validated HRQOL instrument were included. A narrative synthesis of studies was conducted. Results: 19 studies involving 6205 participants; 3780 (61%) were rural were included. Participants’ mean age was 60 years, predominately female (89%) and within 1-5 years post-diagnosis. Most studies were from the United States (n=11) and included rural-only (n=12) and breast cancer-only (n=12) participants. Thirteen different HRQOL questionnaires were used, only two were survivorship specific. Of the seven studies with an urban comparator, seven different HRQOL instruments were used and five focussed on breast cancer only populations.  Of the four studies reporting global HRQOL, two showed better scores in UCS, one in RCS and one found no difference. Within HRQOL domains, RCS had better emotional/psychological/mental (4/7 studies) and functional (2/3 studies) well-being. No differences between cohorts were found in social wellbeing (0/4 studies). Better physical well-being was found in 3/7 studies with RCS, 1/7 study with UCS and 3/7 studies found no difference between cohorts. Conclusion: We cannot elucidate if HRQOL in RCS is better or worse than in UCS. Results were heterogenous in global and subscale scores. Further research requires standardised HRQOL instruments suited to the survivorship phase, greater involvement of people with different cancer types and diversity in geographical locations.