Rural-urban disparities in time to diagnosis and treatment for colorectal and breast cancer

Using population based surveys, this study compared rural and urban patient intervals for colorectal and breast cancer in Victoria, Australia. Six intervals were examined: patient (symptom to presentation), primary care (presentation to referral), diagnostic (presentation/screening to diagnosis), treatment (diagnosis to treatment), health system (presentation to treatment) and total interval (symptom/screening to treatment). Compared to their urban counterparts, symptomatic colorectal cancer patients from rural areas experience significantly longer diagnostic, health system and total intervals. For symptomatic breast cancer patients, the intervals were similar across geographic areas. Unexpectedly, rural patients sought help for symptoms more quickly than urban patients, particularly women with breast cancer. These results show that interventions which target the diagnostic interval in rural areas may reduce to time to treatment, and therefore reduce geographical inequalities in colorectal cancer.

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