Aim:

The mortality of cancer patients living in rural areas is higher, the greater distance they live away from a tertiary centre due to many factors and barriers. The aim of this study is to evaluate patient’s views on barriers to lung cancer diagnosis, and management, in particular of rural patients in North Queensland.

Methods:

As part of a patterns of care lung cancer study, Patients’ view on barriers were explored in a qualitative study using semi-structured interviews lasting up to 30 minutes. Patients from urban and rural areas were recruited from Townsville, Cairns, Mackay and Mt Isa hospitals after informed consent. Transcripts of the interviews were coded and summarised under several themes. Rurality was defined as per standard guidelines.

Results:

Of the 250 patients approached, a total of 230 patients consented to interviews; 86 from Townsville and Cairns, and 144 from rural areas. Main themes relating to patients’ perceived barriers/factors included the following: they delayed their presentations to general practitioners or their referral to the appropriate specialists was delayed, responsibilities (work, family, carer), financial difficulty, delay in investigation and staging, patient refusing investigations, lack of social support, communication barrier (language), environmental hazards (floods, cyclones) and other medical conditions. Rural patients perceived financial difficulty, difficulty travelling to tertiary centres for management, and responsibilities such as work or family, as being key barriers to receiving management. In the urban group, predominant themes included: patient not opting for management, other medical conditions delaying management, and responsibilities such as work.

Conclusions:

Significant modifiable barriers to lung cancer diagnosis and management remains in both urban and rural communities. Rural cancer patient have additional barriers of financial difficulty and difficulty travelling to tertiary centres, in comparison to urban patients. New models of care are needed to address rural barriers.