Aims: Commissioned by Cancer Council Australia, this project aimed to identify (i) barriers and enablers to accessing cancer navigation services for rural and remote Australians, and (ii) rural and remote use of Cancer Council’s 13 11 20 phone line and digital service.
Methods: (i) Narrative review of peer-reviewed and grey literature in the Australian rural/remote context (since 2015), identified from searches across five academic databases and 39 organisations/institutions. (ii) National audit of 13 11 20 service data, collated via consultation with service managers.
Results: (i) From 53 articles and 67 documents, accessibility barriers included lack of local services, travel time and financial burden, limited referrals, complex entry systems, need for privacy in small communities, and beliefs that others were ‘worse off’ or needed the support more. Enablers included community awareness, service-initiated contact, integration with cancer care, central contact point, flexible delivery (on-demand, after-hours), carer-specific support, practical guidance for digital channels, use of visual story-telling, information-sharing with care team, and providers with relevant cultural knowledge and understanding of rural realities. There was evidence of intersectionality with other priority populations (Aboriginal and Torres Strait Islander peoples, older persons, families with children, those with advanced disease). (ii) In 2024, 11,976 (34%) of 13 11 20 connections were from rural and remote areas (49% aged 60-79 years, 73% females, 59% personal history of cancer, 51% advanced or secondary disease, 4% Aboriginal and Torres Strait Islander peoples). Connections were typically first-time users (73%), experiencing moderate distress (49%), and seeking practical information (40%) and psychological/emotional support (31%).
Conclusions: Subsidised telephone and digital delivery of cancer navigation services addresses key barriers, with rural and remote use of 13 11 20 mostly reflecting the wider population, including priority populations. Findings provide practical recommendations for additional service features to optimise access for rural and remote Australians.