Rural Cancer Survivors' Perceived Delays in Seeking Medical Attention, Diagnosis and Treatment: Findings From a Large...

To investigate rural cancer survivors' self-reported reasons for perceived delays in initial cancer detection and treatment.

Within a cohort study, adult cancer survivors who had travelled > 50 km for cancer care, staying at subsidised accommodation lodges in city centres in Queensland, Australia, were invited to complete a structured interview on perceived delays in: (i) seeking medical attention, (ii) receiving their diagnosis and (iii) commencing treatment. Content analysis was used to map self-reported reasons for perceived delays at each step, which were then categorised based on the perceived source: (i) personal, (ii) healthcare professional, (iii) healthcare system or (iv) other. The self-reported reasons and perceived sources were summarised using descriptive statistics.

Six hundred and eighty-six rural cancer survivors completed the interview (18% breast, 15% head and neck, 12% prostate and 12% skin cancer). Almost half (n = 320, 47%) of participants perceived a delay at one or more steps. Delays in seeking medical attention were perceived by 132 (19%) participants, mostly related to personal factors (n = 67, 51%), including misinterpreting (n = 19, 28%) signs and symptoms. Delays in diagnosis were perceived by 161 (23%) participants, mostly related to healthcare professional factors (n = 86, 53%), including requiring further opinions or testing for diagnosis (n = 30, 35%). Delays in commencing treatment were perceived by 157 (23%) participants, mostly due to healthcare system factors (n = 57, 37%), including long waitlists (n = 39, 68%). Of the participants who perceived a delay in commencing treatment, comparison with timeframes recommended in the relevant Optimal Care Pathway identified that 57% of perceived delays were actual delays.

Perceived delays in the pathway to initial cancer detection and treatment are common among rural cancer survivors. Improvements in patient-clinician communication could reduce perceived delays, particularly in diagnosis and treatment. Promoting early help-seeking, participation in cancer screening and improving access to diagnostic and treatment infrastructure may also improve care experiences.