Rural cancer survivors' perceived delays in seeking medical attention, diagnosis, and treatment: A qualitative study

Rural cancer survivors' perceived delays in seeking medical attention, diagnosis, and treatment: A qualitative study

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 subsidized accommodation lodges in city centres throughout Queensland, cancer patients who had travelled > 50 km 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 summarized 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.

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