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

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-07-21 DOI:10.1002/cam4.71036

Alyssa Taglieri-Sclocchi, Ingrid Bindicsova, Susannah K. Ayre, Michael Ireland, Sonja March, Fiona Crawford-Williams, Suzanne Chambers, Jeff Dunn, Belinda C. Goodwin, Elizabeth A. Johnston

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Abstract

Aims

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

Methods

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.

Results

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.

Conclusions

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.

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农村癌症幸存者在寻求医疗、诊断和治疗方面的感知延迟：一项大型定性研究的结果

目的调查农村癌症幸存者自我报告的早期癌症发现和治疗延迟的原因。方法：在一项队列研究中，研究人员邀请旅行50公里到澳大利亚昆士兰州市中心的有补贴的住宿旅馆接受癌症治疗的成年癌症幸存者完成一项结构化访谈，内容涉及以下方面：(i)寻求医疗照顾，（ii）接受诊断，（iii）开始治疗。内容分析用于绘制每个步骤中感知延迟的自我报告原因，然后根据感知来源进行分类：(i)个人，（ii）医疗保健专业人员，（iii）医疗保健系统或（iv）其他。使用描述性统计对自我报告的原因和感知的来源进行总结。结果686名农村癌症幸存者完成了访谈（乳腺癌18%，头颈癌15%，前列腺癌12%，皮肤癌12%）。几乎一半（n = 320, 47%）的参与者认为在一个或多个步骤上有延迟。132名（19%）参与者认为就医延迟，主要与个人因素（n = 67, 51%）有关，包括对体征和症状的误解（n = 19, 28%）。161名（23%）参与者认为诊断延迟，主要与医疗保健专业因素（n = 86,53 %）有关，包括需要进一步的意见或诊断测试（n = 30, 35%）。157名（23%）参与者认为延迟开始治疗，主要是由于医疗保健系统因素（n = 57,37%），包括长等待名单（n = 39,68%）。在感知延迟开始治疗的参与者中，与相关最佳护理途径中推荐的时间框架进行比较，发现57%的感知延迟是实际延迟。结论：在农村癌症幸存者中，早期癌症检测和治疗途径的感知延迟是很常见的。医患沟通的改善可以减少延迟，特别是在诊断和治疗方面。促进早期求助、参与癌症筛查和改善获得诊断和治疗基础设施的机会也可能改善护理体验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.