Does Geography and Place of Residence Affect Cancer Care: An Interview Study

There is existing evidence that rural cancer patients tend to have worse survival outcomes. Potential reasons include: differences in endurance of coping with illness, different attitudes about illness, the nature of rural lifestyles, and poorer access to healthcare services. Some of these factors may affect their delay in presentation of cancer, and/or delay in seeking treatment in a timely manner. Differences in health outcomes between urban and rural populations have been described in a number of health conditions, and to date survival/health outcomes related to cancer have been the most extensively researched. Rurality has been associated with negative impacts on cancer outcomes in studies from the United Kingdom and elsewhere. However, as with rural health disadvantage overall, the underlying causes are uncertain. There is some evidence that rural populations are less likely to engage with screening services and receive lower rates of chemotherapy and surgery. If restricted access to services was the major determinant of poorer cancer outcomes for rural populations, this should also be reflected in longer delays to diagnosis and treatment for cancer for those patients living more remotely. However, a recent study from the Northeast of Scotland contradicts this, finding that rural patients in Scotland were diagnosed and treated for their cancers quicker than their urban counterparts, but died earlier . The investigator's proposed research aims to provide insights into differences between how urban and rural patients engage with health services in National Health Service (NHS) Grampian by interviewing patients about their diagnostic pathway, their interactions with the healthcare service, their treatment choices, and how these may have been influenced by where they live.

Sex

All

Minimum age

18 Years

Maximum age

100 Years

Inclusion Criteria:

* Patients will be eligible to participate if they are adults, 18 years or over, confirmed cancer diagnosis from the top eight cancer sites (lung, oesophageal, colorectal, breast, pancreatic, prostate, kidney, and bladder) within the last 2 years. Participants can have all stages and all grades of cancer as long as they feel able to provide a full interview for approximately 45 minutes. There will be an opportunity for patient to opt into telephone interviews. Interviewees are able to stop their interviews at any moment without having to give a reason.

Exclusion Criteria:

* The research team involved in recruiting will exclude patients that are unable to give consent, non-English speaking patients, patients under the age of 18 and patients that are too ill based on the observation of the clinical staff.

This study will exclude persons who have difficulty understanding verbal explanations in English. This study is a small qualitative study based upon interviews conducted by a single researcher in the English language. The analysis of the data will depend upon specific words and utterances which are used by the participant. Meaning will be derived from words, phrases, and utterances and will be reliant upon the participant being able to communicate in the English language.

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