Aims
People living in rural and remote Australia experience poorer cancer outcomes and less equitable access to best-practice cancer care than metropolitan counterparts. This study explored barriers and facilitators to accessing timely cancer diagnosis and treatment from the perspectives of people with cancer and family carers.
Methods
This qualitative study, informed by the Levesque framework, forms part of the Equitable Cancer Outcomes across Rural and Remote Australia (ECORRA) Trial. People diagnosed with cancer and carers supporting a family member through cancer diagnosis and/or treatment in rural and remote Australia were recruited through social media. Demographic data were collected via an online survey, and semi-structured interviews were conducted via Microsoft Teams. Interviews were analysed deductively using the Levesque framework, with inductive analysis identifying unique experiences.
Results
Twenty-two interviews were completed with people diagnosed with cancer (n=18) and family carers (n=4). Most participants were female (n=20) and described care received across South Australia, Queensland, and Victoria. Delays concentrated in the diagnostic pathway were driven by prolonged general practitioner wait times, information gaps, delayed investigation following reassuring initial assessments, and limited local diagnostic services. Access to diagnosis and treatment was further constrained by distance, centralisation of specialist services, travel-related financial burden, and fragmented coordination across healthcare providers, services, and jurisdictions. Participants consistently described the need to self-advocate to navigate the health system. Key enablers included trusted relationships with healthcare providers, culturally safe care, effective communication and coordination among healthcare providers and services, outreach and locally delivered services, telehealth, travel and accommodation support, and care navigation.
Conclusions
Access to timely cancer diagnosis and treatment in rural and remote Australia is heavily influenced by the availability, affordability, appropriateness, and coordination of care. Strengthening care coordination, navigation support, information provision at diagnosis, and outreach and decentralised models of care may improve equitable access to cancer care.