Patterns of Care and Treatment Outcomes Among Men Diagnosed with Prostate Cancer from Culturally and Linguistically Diverse Backgrounds: A Scoping Review.

Introduction: Men from culturally and linguistically diverse (CALD) backgrounds face challenges in accessing equitable and quality healthcare. However, little is known about the patterns of care among men diagnosed with prostate cancer (PCa) from CALD backgrounds. We aimed to map the available literature on patterns of care and treatment outcomes in men from CALD backgrounds who have PCa.

Methods: We used the Johanna Briggs Institute scoping review methodology. We searched five bibliographic databases (Ovid MEDLINE, EMBASE, SCOPUS, CINAHL, and Ovid Emcare) and grey literature. We explored patterns of PCa care extending from screening and early detection to end-of-life care and treatment outcomes.

Results: A total of 7,148 records were identified; 58 studies were included. Most studies were from the United States (US) (n = 41) and used ethnic origin (n = 14), nativity (n = 10), immigration history (n = 11), or country of birth (n = 13) as indicators of CALD. Most studies focused on screening and early detection for PCa (n = 37), specifically prostate-specific antigen (PSA) testing. Twelve papers were on PCa treatment (e.g., surgery, radiation therapy, and active surveillance), five on follow-up and supportive care, and four on treatment outcomes (i.e., change in measured PSA and PCa cancer-specific survival). There were disparities in the PCa care continuum and treatment outcomes between CALD and non-CALD patients. Factors influencing screening and early detection for PCa were systematically summarised and most addressed individual-level determinants.

Conclusions: Key findings from our scoping review emphasised the existence of guideline-discordant care, disparities in PCa screening test use, and differences in PCa treatment received among men from CALD backgrounds. However, little is known about patterns of care in diagnostic modalities, treatment phases, and palliative and end-of-life care.