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
{"title":"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","authors":"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","doi":"10.1002/cam4.71036","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>To investigate rural cancer survivors' self-reported reasons for perceived delays in initial cancer detection and treatment.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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 (<i>n</i> = 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 (<i>n</i> = 67, 51%), including misinterpreting (<i>n</i> = 19, 28%) signs and symptoms. Delays in diagnosis were perceived by 161 (23%) participants, mostly related to healthcare professional factors (<i>n</i> = 86, 53%), including requiring further opinions or testing for diagnosis (<i>n</i> = 30, 35%). Delays in commencing treatment were perceived by 157 (23%) participants, mostly due to healthcare system factors (<i>n</i> = 57, 37%), including long waitlists (<i>n</i> = 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.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 14","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71036","citationCount":"0","resultStr":"{\"title\":\"Rural Cancer Survivors' Perceived Delays in Seeking Medical Attention, Diagnosis and Treatment: Findings From a Large Qualitative Study\",\"authors\":\"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\",\"doi\":\"10.1002/cam4.71036\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>To investigate rural cancer survivors' self-reported reasons for perceived delays in initial cancer detection and treatment.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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 (<i>n</i> = 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 (<i>n</i> = 67, 51%), including misinterpreting (<i>n</i> = 19, 28%) signs and symptoms. Delays in diagnosis were perceived by 161 (23%) participants, mostly related to healthcare professional factors (<i>n</i> = 86, 53%), including requiring further opinions or testing for diagnosis (<i>n</i> = 30, 35%). Delays in commencing treatment were perceived by 157 (23%) participants, mostly due to healthcare system factors (<i>n</i> = 57, 37%), including long waitlists (<i>n</i> = 39, 68%). 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Rural Cancer Survivors' Perceived Delays in Seeking Medical Attention, Diagnosis and Treatment: Findings From a Large Qualitative Study
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.
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.
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