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Inequalities and Barriers to the Use of Health Care among Cancer Patients in the Pacific: A Systematic Review

Mohammadnezhad M, Mangum T and Konrote A

Introduction and aim: According to the WHO, the cancer threat is expected to rise by over 70% within the next two decades. To prevent cancer and reduce the consequences of cancer among patients it is essential to understand the barriers. Due to the close relation between the barriers, and also inequality on one side and lack of previous study among Pacific countries on the other side, this systematic review was conducted to understand inequalities and barriers to the use of health care among cancer patients in the Pacific.

Methods: This systematic review was conducted using five of the more frequently use databases and was based on the Cochrane Library Guidelines. Specific keywords were used to attain the relevant studies; with the search being focused on studies published between 1st January 2000 to 1st July 2017, published in English in the peer reviewed journals, and with full text was available. Two independent coders reviewed all studies and the essential information was chosen to develop the data extraction sheet. A descriptive statistical analysis was applied and the frequency and percentage of the studies was shown in tables.

Results: Overall, 38 studies met the inclusion criteria. American Pacific countries conducted a majority of the studies (57.89%) and 28.94% of studies were carried out among both male and female participants. Out of 38 studies, 33 used the quantitative method and 5 studies applied the qualitative. Socio-demographic, personal and subjective, and health facilities related factors were the barriers determined in this study. Lack of knowledge (11 studies) was considered the most common socio-demographic related barrier, while a cultural barrier (9 studies) was the more frequent barrier in personal and subjective. Limited cancer prevention services (11 studies) were determined as the most frequent barrier related to health facilities related factors.

Conclusion: The results of this study highlighted the role of the main barriers in health care among cancer patients in the Pacific. There are many barriers which can lead inequality among Pacific patients; to reduce inequality among cancer patients, health care professionals, policy makers and local ministries of health need to pay more attention to the barriers highlighted in this study.