Department of Oncology, Monash Health, Clayton, Victoria, Australia.
Department of Oncology, Eastern Health, Box Hill, Victoria, Australia.
Support Care Cancer. 2024 Jun 12;32(7):424. doi: 10.1007/s00520-024-08618-9.
We conducted a systematic review to describe health-related quality of life (HRQOL) in rural cancer survivors (RCS), and compare HRQOL between RCS and urban cancer survivors (UCS).
We searched Medline, Embase, CINAHL Plus, and PsycINFO for studies with HRQOL in adult cancer survivors living in rural, regional, remote, and urban areas, who had completed definitive primary cancer treatment, without evidence of residual disease. Where available, we used normative and clinically important values to ascribe meaning to HRQOL data.
Fifteen studies (16 papers) were included. Most were from the US (n = 8) and reported on breast cancer survivors (n = 9). Six HRQOL instruments, collecting data across 16 domains, were used. Three instruments were specific to the survivorship phase. Normative and clinical data were available for 12 studies. Compared with normative populations, RCS had clinically worse physical HRQOL (6/12 studies), better social/family (5/7), and functional (3/6) HRQOL, and there were no differences in emotional or/mental HRQOL (9/12). In six studies with rural-urban comparator groups and normative and clinically important data, RCS and UCS had clinically worse physical (3/6 and 2/6, respectively) and better social/family (3/4 and 2/4 studies, respectively) HRQOL than normative populations. Functional HRQOL was better in RCS (2/4 studies) than UCS and normative populations. In 3/6 studies, there were no clinical differences in emotional or/mental HRQOL between RCS, UCS, and normative populations.
Overall, HRQOL is not clearly better or worse in RCS than UCS. Future research should include different tumor types, rural residents, and survivorship-specific HRQOL instruments.
我们进行了一项系统评价，旨在描述农村癌症幸存者（RCS）的健康相关生活质量（HRQOL），并比较 RCS 和城市癌症幸存者（UCS）之间的 HRQOL。
我们检索了 Medline、Embase、CINAHL Plus 和 PsycINFO，以获取在农村、地区、偏远地区和城市地区居住的成年癌症幸存者的 HRQOL 研究，这些患者已完成确定性原发性癌症治疗，且无残留疾病证据。在有可用数据的情况下，我们使用了规范和临床重要的值来赋予 HRQOL 数据意义。
共纳入 15 项研究（16 篇论文）。这些研究大多来自美国（n=8），并报告了乳腺癌幸存者（n=9）的情况。使用了 6 种 HRQOL 工具，涵盖了 16 个领域的数据。其中 3 种工具是专门针对生存阶段的。有 12 项研究提供了规范和临床数据。与规范人群相比，RCS 的身体 HRQOL 较差（6/12 项研究），社会/家庭功能较好（5/7 项），功能状态较好（3/6 项），而情感或/心理 HRQOL 没有差异（9/12 项）。在 6 项具有农村-城市比较组和规范及临床重要数据的研究中，RCS 和 UCS 的身体（3/6 和 2/6）和社会/家庭（3/4 和 2/4）HRQOL 均比规范人群差。RCS 的功能 HRQOL 比 UCS 和规范人群好（2/4 项研究）。在 3/6 项研究中，RCS、UCS 和规范人群之间的情感或/心理 HRQOL 没有临床差异。
总体而言，RCS 的 HRQOL 并不明显优于或劣于 UCS。未来的研究应包括不同的肿瘤类型、农村居民和生存特异性 HRQOL 工具。
