Barriers to early presentation amongst rural residents experiencing symptoms of colorectal cancer: a qualitative interview study

Dobson, C., Deane, J., Macdonald, S. , Murchie, P., Ellwood, C., Angell, L. and Rubin, G. (2023) Barriers to early presentation amongst rural residents experiencing symptoms of colorectal cancer: a qualitative interview study. Cancers, 15(1), 274. (doi: 10.3390/cancers15010274) (PMID:36612270) (PMCID:PMC9818976)

Abstract

Rural cancer inequalities are evident internationally, with rural cancer patients 5% less likely to survive than their urban counterparts. There is evidence to suggest that diagnostic delays prior to entry into secondary care may be contributing to these poorer rural cancer outcomes. This study explores the symptom appraisal and help-seeking decision-making of people experiencing symptoms of colorectal cancer in rural areas of England. Patients were randomly invited from 4 rural practices, serving diverse communities. Semi-structured interviews were undertaken with 40 people who had experienced symptoms of colorectal cancer in the preceding 8 weeks. Four key themes were identified as influential in participants’ willingness and timeliness of consultation: a desire to rule out cancer (facilitator of help-seeking); stoicism and self-reliance (barrier to help-seeking); time scarcity (barrier to help-seeking); and GP/patient relationship (barrier or facilitator, depending on perceived strength of the relationship). Self-employed, and “native” rural residents most commonly reported experiencing time scarcity and poor GP/patient relationships as a barrier to (re-)consultation. Targeted, active safety-netting approaches, and increased continuity of care, may be particularly beneficial to expedite timely diagnoses and minimise cancer inequalities for rural populations.

• Item Type: Articles
• Additional Information: This research was funded by Yorkshire Cancer Research, grant NEW413.
• Keywords: Help-seeking, cancer inequalities, rurality, diagnostic delays, early diagnosis, colorectal cancer.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Macdonald, Professor Sara

Creator Roles

Macdonald, S.: Conceptualization, Writing – review and editing

• Authors: Dobson, C., Deane, J., Macdonald, S., Murchie, P., Ellwood, C., Angell, L., and Rubin, G.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Cancers
• Publisher: MDPI
• ISSN: 2072-6694
• ISSN (Online): 2072-6694
• Published Online: 31 December 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Cancers 15(1): 274
• Publisher Policy: Reproduced under a Creative Commons License