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Systematic review of the association between socioeconomic status and bladder cancer survival with hospital type, comorbidities, and treatment delay as mediators
Department of Translational Oncology and Urology Research School of Cancer and Pharmaceutical Sciences King's College London London UK.ORCID iD: 0000-0001-5640-8425
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine. Department of Surgical Sciences Uppsala University Uppsala Sweden.ORCID iD: 0000-0001-6808-4405
Department of Translational Oncology and Urology Research School of Cancer and Pharmaceutical Sciences King's College London London UK; Department of Surgical Sciences Uppsala University Uppsala Sweden.
Department of Urology Skåne University Hospital Malmö Sweden; Institution of Translational Medicine Lund University Malmö Sweden.
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2021 (English)In: BJUI Compass, ISSN 2688-4526, Vol. 2, no 3, p. 140-158Article, review/survey (Refereed) Published
Abstract [en]

Objectives:  To review the current evidence on the relationship between three proposed mediators (comorbidities, hospital type, and treatment delays) for the relationship between socioeconomic status (SES) and bladder cancer survival.

Materials and methods:  Six different searches using OVID (Medline and Embase) were carried out to collate information available between the proposed mediators with both SES and survival in bladder cancer. This systematic review was conducted according to a pre-defined protocol and in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results:  A total of 49 studies were included in the review across the six searches (one appeared in two searches). There was a wealth of studies investigating the relationship between each of the proposed mediators with survival in bladder cancer patients. In general, a higher SES, lower comorbidities, and a larger hospital volume were all found to be associated with a decreased risk of death in bladder cancer patients. There was, however, a paucity of studies investigating the associations between these mediators and SES in bladder cancer patients.

Conclusions:  To gain a deeper understanding of the relationship between SES and survival identified in several observational studies, further investigations into the relationship between the proposed mediators and SES are warranted. Moreover, modifiable mediators, eg, treatment delay, highlight the importance of the standardization of clinical care across SES groups for all bladder cancer patients.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021. Vol. 2, no 3, p. 140-158
Keywords [en]
bladder cancer, mediation, socioeconomic status, survival, systematic review
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:umu:diva-196211DOI: 10.1002/bco2.65PubMedID: 35475135OAI: oai:DiVA.org:umu-196211DiVA, id: diva2:1666975
Available from: 2022-06-09 Created: 2022-06-09 Last updated: 2023-05-24Bibliographically approved

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Häggström, Christel

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Russell, BethHäggström, ChristelBryan, Richard TVan Hemelrijck, Mieke
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