Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Rural cancer survivors’ perceived delays in seeking medical attention, diagnosis, and treatment: A qualitative study (#25)

Alyssa Taglieri-Sclocchi 1 , Ingrid Bindicsova 1 2 , Susannah K. Ayre 1 3 , Michael Ireland 4 5 , Sonja March 4 5 , Fiona Crawford-Williams 6 7 , Jeff Dunn 1 5 8 9 10 , Suzanne Chambers 8 9 11 12 , Belinda C. Goodwin 1 5 13 , Elizabeth A. Johnston 1 3 14
  1. Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
  2. School of Psychology, University of Queensland, St Lucia, Queensland, Australia
  3. School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia
  4. School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Queensland, Australia
  5. Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
  6. College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
  7. McGrath Foundation, Sydney, New South Wales, Australia
  8. Faculty of Health Sciences, Australian Catholic University, Banyo, Queensland, Australia
  9. Menzies Health Institute Queensland, Griffith University, Mt Gravatt, Queensland, Australia
  10. Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia
  11. Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
  12. St Vincent’s Health Network Sydney, Sydney, New South Wales, Australia
  13. School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  14. Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia

Aims: To investigate perceived delays in seeking medical attention, receiving their diagnosis, and starting cancer treatment among rural cancer survivors, a population group that experiences inequities in cancer outcomes.

Methods: Through subsidised accommodation lodges in city centres throughout Queensland, cancer patients who had travelled >50km for cancer treatment were invited to participate in a structured interview collecting information on reasons for any perceived delays in seeking medical attention, receiving their diagnosis, and starting cancer treatment. Content analysis was used to identify reasons for perceived delays and summarised using descriptive statistics.

Results: Interviews were completed by 686 rural cancer patients (54% male; 51% outer regional or remote; 18% breast, 16% head and neck, 12% prostate, 12% skin cancer). Most participants did not report a delay in seeking medical attention (n=554; 81%), receiving their diagnosis (n=525; 77%), and starting cancer treatment (n=529; 77%). Of those that reported a delay in seeking medical attention (n=132; 19%), most perceived the delay was due to personal reasons, such as deciding not to seek medical care immediately, postponing screening, and employment demands. Of those that reported a delay in receiving their diagnosis (n=161; 23%), most perceived the delay was due to medical personnel, including the healthcare professional requiring multiple opinions and/or further tests/scans prior to diagnosis or being initially misdiagnosed. Of those that reported a delay in starting cancer treatment (n=157; 23%), most perceived the delay was caused by challenges accessing the health system, most commonly long waitlists and travel distances for treatment.

Conclusions: Around one in five rural cancer patients perceived a delay in their cancer care, particularly in receiving their diagnosis and starting treatment. Ongoing efforts to implement optimal care pathways in rural health services as well as increasing participation in cancer screening and early help-seeking in rural areas, may improve patient care experiences.