The psychosocial experience of cancer: a meta-analysis of Australian rural versus urban populations

Figures & data

Figure 1. PRISMA flow diagram of excluded and included studies.

Table 1. Key descriptive characteristics of studies and meta-analytic results.

	Study (year)	N Rural/urban	Rural Coding	Study Design	Cancer type	Distress Measure	Australian Location	Study Quality*	Weighting	Odds Ratio (95%CI)
1.	Ahern et al. (2015)	101/224	Remoteness Area (RA)	Cross-sectional	Breast	Unmet support needs	National	Good	5.27%	1.87 (1.01, 3.46)
2.	Bui et al. (2020)	21/165	ARIA	Cross-sectional	Advanced Various	Anxiety	NSW	Good	4.54%	2.02 (0.77, 5.28)
3.	Corboy et al. (2014)	161/286	ARIA+	Cross-sectional	Prostate	Emotional wellbeing	National	Very Good	5.69%	1.81 (1.27, 2.57)
4.	DiSipio et al. (2010)	323/277	ARIA+	Cross-sectional	Breast	Emotional wellbeing	QLD	Very good	5.62%	1.07 (0.71, 1.60)
5.	Eggins et al. (2022)	1179/1456	ARIA+	Cross-sectional	Breast	Psychological unmet needs	QLD	Very Good	5.89%	1.03 (0.90, 1.19)
6.	Elder-Robinson et al. (2022)	29/34	ARIA+	Cross-sectional	Various	Quality of life	Northern Territory	Very Good	4.64%	2.137 (0.86, 5.3)
7.	Girgis et al. (2000)	129/100	Own classification	Cross-sectional	Breast	Psychological unmet needs	NSW	Very good	5.40%	1.43 (0.83, 2.44)
8.	Gunn et al. (2020)	916/3379	Not stated	Cross-sectional	Various	Distress	South Australia	Very good	5.78%	0.71 (0.54, 0.94)
9.	Hall et al. (2016)	270/1144	ARIA+	Cross-sectional	Haematological	Distress	National	Very good	5.74%	1.08 (0.79, 1.48)
10.	Lashbrook et al. (2018)	85/49	ARIA	Cross-sectional	Various	Distress	NSW	Good	4.71%	1.57 (0.65, 3.79)
11.	Leach et al. (2020)	356/NR	RA	Cross-Sectional	Various	Emotional health	South Australia	Very good	3.50%	6.03 (1.43, 25.42)
12.	Pateman et al. (2018)	47/48	RA	Longitudinal	Head/Neck	Quality of life	Brisbane, QLD	Very good	4.85%	0.08 (0.04, 0.183)
13.	Paul et al. (2013)	119/149	ARIA+	Cross-sectional	Haematological	Distress	Western Australia	Very good	5.26%	12.10 (6.55, 22.34)
14.	Tzelepis et al. (2018)	272/1145	ARIA+	Survey	Haematological	Emotional Health	National	Very good	5.61%	0.93 (0.62, 1.39)
15.	Watts et al. (2016)	374/67	ARIA+	Cross-sectional	Various	Emotional Problems	Western Australia	Very good	5.05%	1.51 (0.74, 3.11)
16.	White et al. (2011)	403/383	Adapted RA	Cross-sectional	Various	Unmet needs	Western Australia	Very good	5.64%	0.92 (0.63, 1.36)
17.	Youl et al. (2019)	450/365	ABS Remoteness Structure	Cross-sectional	Breast	Burdens	National	Good	5.73%	1.61 (1.17, 2.22)
18.	Zajdleiwcz et al. (2015)	435/596	ABS Remoteness Structure	Cross-sectional	Various	Emotional concerns	QLD	Very Good	5.29%	1.44 (0.79, 2.62)
19.	Zucca et al. (2011)	520/890	ARIA+	Longitudinal	Various	Burdens	NSW & Victoria	Very good	5.79%	10.55 (8.07, 13.78)
		Rural N = 6190, Urban N = 10757						Total	100%	1.54 (1.01, 2.35)
								Test for overall effect	Z = 2.011 (p = 0.044)

NR = Not Reported; QLD = Queensland; NSW = New South Wales. Study quality as per Joanna Briggs Institute checklist.

Figure 2. Analytic Outcomes for Breast Cancers.

Figure 3. Analytic Outcomes for Mixed Cancers.

Ahern, T., Gardner, A., & Courtney, M. (2015). Geographical comparisons of information and support needs of Australian women following the primary treatment of breast cancer: A 10-year replication study. Health Expectations, 18(6), 2678–2692. https://doi.org/10.1111/hex.12242

 PubMed Web of Science ®Google Scholar

Bui, K. T., Dhillon, H. M., Brown, C., Xu, K., Shafiei, M., Kiely, B. E., & Blinman, P. (2020). Prevalence and severity of scanxiety in people with advanced cancers: Final results of a multi-centre survey [Conference abstract]. Asia-Pacific Journal of Clinical Oncology, 16(Suppl. 2), 23–24. https://doi.org/10.1111/ajco.13416

 Google Scholar

Corboy, D., McLaren, S., Jenkins, M., & McDonald, J. (2014). The relationship between geographic remoteness and intentions to use a telephone support service among Australian men following radical prostatectomy. Psycho-Oncology, 23(11), 1259–1266. https://doi.org/10.1002/pon.3559

 PubMed Web of Science ®Google Scholar

DiSipio, T., Hayes, S. C., Newman, B., Aitken, J., & Janda, M. (2010). Does quality of life among breast cancer survivors one year after diagnosis differ depending on urban and non-urban residence? A comparative study. Health and Quality of Life Outcomes, 8(1), 3. https://doi.org/10.1186/1477-7525-8-3

 PubMedGoogle Scholar

Eggins, R., Fowler, H., Cameron, J., Aitken, J. F., Youl, P., Turrell, G., Chambers, S. K., Dunn, J., Pyke, C., Baade, P. D., & Goodwin, B. (2022, November). Supportive care needs and psychosocial outcomes of rural versus urban women with breast cancer. Psychooncology, 31(11), 1951–1957. https://doi.org/10.1002/pon.5977

 PubMed Web of Science ®Google Scholar

Elder-Robinson, E., Diaz, A., Howard, K., Parikh, D. R., Kar, G., & Garvey, G. (2022). Quality of life in the first year of cancer diagnosis among aboriginal and non-aboriginal people living in regional and remote areas of Australia. International Journal of Environmental Research and Public Health, 19(1). https://doi.org/10.3390/ijerph19010330

 PubMed Web of Science ®Google Scholar

Girgis, A., Boyes, A., Sanson‐Fisher, R. W., & Burrows, S. (2000). Perceived needs of women diagnosed with breast cancer: Rural versus urban location. Australian and New Zealand Journal of Public Health, 24(2), 166–173. https://doi.org/10.1111/j.1467-842X.2000.tb00137.x

 PubMed Web of Science ®Google Scholar

Gunn, K. M., Berry, N. M., Meng, X., Wilson, C. J., Dollman, J., Woodman, R. J., Clark, R. A., & Koczwara, B. (2020). Differences in the health, mental health and health-promoting behaviours of rural versus urban cancer survivors in Australia. Supportive Care in Cancer, 28(2), 633–643. https://doi.org/10.1007/s00520-019-04822-0

 PubMed Web of Science ®Google Scholar

Hall, A. E., Sanson-Fisher, R. W., Carey, M. L., Paul, C., Williamson, A., Bradstock, K., & Campbell, H. S. (2016). Prevalence and associates of psychological distress in haematological cancer survivors. Supportive Care in Cancer, 24(10), 4413–4422. https://doi.org/10.1007/s00520-016-3282-3

 PubMed Web of Science ®Google Scholar

Lashbrook, M., Bernardes, C. M., Kirshbaum, M. N., & Valery, P. C. (2018). Physical functioning and psychological morbidity among regional and rural cancer survivors: A report from a regional cancer centre. The Australian Journal of Rural Health, 26(3), 211–219. https://doi.org/10.1111/ajr.12419

 PubMed Web of Science ®Google Scholar

Leach, M. J., Gillam, M., Gonzalez‐Chica, D. A., Walsh, S., Muyambi, K., & Jones, M. (2020). Health care need and health disparities: Findings from the Regional South Australia Health (RESONATE) survey. Health & Social Care in the Community. https://doi.org/10.1111/hsc.13124

 PubMed Web of Science ®Google Scholar

Pateman, K. A., Cockburn, N. L., Batstone, M. D., & Ford, P. J. (2018). Quality of life of head and neck cancer patients in urban and regional areas: An Australian perspective. The Australian Journal of Rural Health, 26(3), 157–164. https://doi.org/10.1111/ajr.12340

 PubMed Web of Science ®Google Scholar

Paul, C. L., Hall, A. E., Carey, M. L., Cameron, E. C., & Clinton McHarg, T. (2013). Access to care and impacts of cancer on daily life: Do they differ for metropolitan versus regional hematological cancer survivors? The Journal of Rural Health, 29(Suppl 1), s43–50. https://doi.org/10.1111/jrh.12020

 PubMedGoogle Scholar

Tzelepis, F., Paul, C. L., Sanson-Fisher, R. W., Campbell, H. S., Bradstock, K., Carey, M. L., & Williamson, A. (2018). Unmet supportive care needs of haematological cancer survivors: Rural versus urban residents. Annals of Hematology, 97(7), 1283–1292. https://doi.org/10.1007/s00277-018-3285-x

 PubMed Web of Science ®Google Scholar

Watts, K. J., Good, L. H., McKiernan, S., Miller, L., O'Connor, M., Kane, R., Kruger, D. J., Adams, B. R., & Musiello, T. (2016). ”Undressing” distress among cancer patients living in urban, regional, and remote locations in Western Australia. Support Care Cancer, 24(5), 1963–1973. https://doi.org/10.1007/s00520-015-2982-4

 PubMed Web of Science ®Google Scholar

White, K., Roydhouse, J., D'Abrew, N., Katris, P., O'Connor, M., & Emery, L. (2011). Unmet psychological and practical needs of patients with cancer in rural and remote areas of Western Australia. Rural and Remote Health, 1, 1–11. https://doi.org/10.3316/informit.334387320826109

 Google Scholar

Youl, P., Morris, B., Anderson, J., & Morstyn, L. (2019). What factors influence the treatment decisions of women with breast cancer? Does residential location play a role? Rural and Remote Health, 19(2). https://doi.org/10.3316/informit.143417998400817

 PubMed Web of Science ®Google Scholar

Zajdleiwcz, L., Dunn, J., Hyde, M., & Aitken, J. (2015). The 1000-survivor study [Conference abstract]. Psycho-Oncology, 24, 234–235. https://doi.org/10.1002/pon.3874

 Google Scholar

Zucca, A., Boyes, A., Newling, G., Hall, A., & Girgis, A. (2011). Travelling all over the countryside: Travel‐related burden and financial difficulties reported by cancer patients in New South Wales and Victoria. The Australian Journal of Rural Health, 19(6), 298–305. https://doi.org/10.1111/j.1440-1584.2011.01232.x

 PubMed Web of Science ®Google Scholar

Data availability statement

Data from this study will be made available upon reasonable request at the conclusion of this research project, once all associated research articles are finalised and published.