Gender-specific differences in care-seeking behaviour among lung cancer patients: a systematic review

Background: In the literature, men are often described as unwilling to use healthcare services, whereas women as frequent users. We conducted a systematic literature review to examine the gender differences in healthcare utilisation of lung cancer patients. Our aim was to synthesise evidence to assess whether men and women utilise cancer diagnosis and treatments differently. Methods: The databases of PubMed, Scopus, Web of Science, EBSCO Host, Ovid nursing, and Cochrane was systematically searched. We used pre-defined eligibility criteria to identify peer-reviewed published literature that reported healthcare use of lung cancer patients. Two reviewers independently screened the title, abstract, full texts and retrieved relevant data. Results: A total of 42 studies met the eligibility criteria from 1356 potential studies. In these studies, the most commonly measured healthcare utilisation is surgery (n = 19), followed by chemotherapy (n = 13). All the studies were from developed countries and had a higher percentage of male participants. Substantial evidence of heterogeneity in the use of treatments by gender were found. In relation to diagnosis interval and stage of cancer diagnosis, it was found that women had longer diagnostic intervals. Nonetheless, women tend to get diagnosed at an earlier stage. Furthermore, women had a higher probability of using inpatient cancer-care services and surgical treatments. Conversely, men had greater risks of readmission after surgery and longer length of stay. Lastly, there were no significant gender differences in the likelihood of receiving chemotherapy and radiation therapy. Conclusion: This study synthesised evidence of disparities in the use of lung cancer treatments based on gender in developed countries, with no evidence available from least-developed and developing countries. Further studies are required to understand this gender-specific inequality and to design interventions to improve the survival rate of lung cancer patients