Background: People living in rural areas have worse outcomes from cancer compared to their metropolitan counterparts. Whilst some of the difference in survival data is driven by access to primary care and late presentation, part is triggered by perceived or actual lack of access to treatments and care. In Western NSW, fewer than 10% of patients diagnosed with cancer seek treatment outside the district. The development of a new integrated cancer centre (Western Cancer Centre, WCC) in Dubbo with a network of remote video assisted chemotherapy centres across its 250 000 square kilometre footprint has increased the visibility and provision of cancer services.
Aims: To compare growth in parenteral cancer therapeutic treatment delivery at the WCC and its remote video assisted chemotherapy sites with similar established integrated cancer centres within Western NSW.
Results: Between 2018 and 2025, the occasions of parenteral treatments across the catchment of the WCC increased from 4345 occasions per annum to 8180 per annum, roughly an 88% increase. At other cancer centres in Western NSW LHD, these treatments increased from 7211 per annum to 8848 per annum (22.7% growth). A difference-in-difference analysis showed the change in treatments in the three years before the opening of the WCC compared with the most recent three years to be an additional 1798 treatments than expected per annum (95%CI 361-3234, p=0.022). Occasions of service in 2025 per 1000 population is similar in both groups, 65.2 in WCC, 63.2 in comparable sites.
Discussion: The growth from 2018 to 2025 shows that Dubbo is catching up with unmet need. Baseline growth in parenteral treatments was approximately 22.7%, which reflects growth in cancer diagnosis and improved treatment options and benefit. Qualitative surveys would be beneficial in describing the effect of proximity to home of integrated cancer centres.