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

NCT03836794 | Completed

• 1 other identifier: 2-109-18
• Study Type: observational
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Cancer

Outcome Measures

Primary Outcomes (1)

• Qualitive Measures of a Study Questionnaire

  Interviewing 25 patients, rich, explanatory qualitative data from patients about their path to diagnosis and their path to treatment and how that may have been influenced by where they live.

  1 year

Eligibility Criteria

• Age: 18 Years - 100 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The recruited population will be newly diagnosed cancer patients

You may qualify if:

• 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.

You may not qualify if:

• 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.

Sponsors & Collaborators

• University of Aberdeen: lead

Study Sites (1)

Aberdeen Royal Infirmary

Aberdeen, Aberdeenshire, AB25 2ZN, United Kingdom

Location

Related Publications (9)

• Tonelli M, Wiebe N, Fortin M, Guthrie B, Hemmelgarn BR, James MT, Klarenbach SW, Lewanczuk R, Manns BJ, Ronksley P, Sargious P, Straus S, Quan H; Alberta Kidney Disease Network. Methods for identifying 30 chronic conditions: application to administrative data. BMC Med Inform Decis Mak. 2015 Apr 17;15:31. doi: 10.1186/s12911-015-0155-5.

  PMID: 25886580 BACKGROUND

• Carriere R, Adam R, Fielding S, Barlas R, Ong Y, Murchie P. Rural dwellers are less likely to survive cancer - An international review and meta-analysis. Health Place. 2018 Sep;53:219-227. doi: 10.1016/j.healthplace.2018.08.010. Epub 2018 Sep 5.

  PMID: 30193178 BACKGROUND

• Jones AP, Haynes R, Sauerzapf V, Crawford SM, Zhao H, Forman D. Travel time to hospital and treatment for breast, colon, rectum, lung, ovary and prostate cancer. Eur J Cancer. 2008 May;44(7):992-9. doi: 10.1016/j.ejca.2008.02.001. Epub 2008 Mar 28.

  PMID: 18375117 BACKGROUND

• Campbell NC, Elliott AM, Sharp L, Ritchie LD, Cassidy J, Little J. Impact of deprivation and rural residence on treatment of colorectal and lung cancer. Br J Cancer. 2002 Sep 9;87(6):585-90. doi: 10.1038/sj.bjc.6600515.

  PMID: 12237766 BACKGROUND

• Jones AP, Haynes R, Sauerzapf V, Crawford SM, Zhao H, Forman D. Travel times to health care and survival from cancers in Northern England. Eur J Cancer. 2008 Jan;44(2):269-74. doi: 10.1016/j.ejca.2007.07.028. Epub 2007 Sep 20.

  PMID: 17888651 BACKGROUND

• Lin CC, Bruinooge SS, Kirkwood MK, Olsen C, Jemal A, Bajorin D, Giordano SH, Goldstein M, Guadagnolo BA, Kosty M, Hopkins S, Yu JB, Arnone A, Hanley A, Stevens S, Hershman DL. Association Between Geographic Access to Cancer Care, Insurance, and Receipt of Chemotherapy: Geographic Distribution of Oncologists and Travel Distance. J Clin Oncol. 2015 Oct 1;33(28):3177-85. doi: 10.1200/JCO.2015.61.1558. Epub 2015 Aug 24.

  PMID: 26304878 BACKGROUND

• Turner M, Fielding S, Ong Y, Dibben C, Feng Z, Brewster DH, Black C, Lee A, Murchie P. A cancer geography paradox? Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a data-linkage study. Br J Cancer. 2017 Jul 25;117(3):439-449. doi: 10.1038/bjc.2017.180. Epub 2017 Jun 22.

  PMID: 28641316 BACKGROUND

• Williams S, Bi P, Newbury J, Robinson G, Pisaniello D, Saniotis A, Hansen A. Extreme heat and health: perspectives from health service providers in rural and remote communities in South Australia. Int J Environ Res Public Health. 2013 Oct 29;10(11):5565-83. doi: 10.3390/ijerph10115565.

  PMID: 24173140 BACKGROUND

• Murage P, Murchie P, Bachmann M, Crawford M, Jones A. Impact of travel time and rurality on presentation and outcomes of symptomatic colorectal cancer: a cross-sectional cohort study in primary care. Br J Gen Pract. 2017 Jul;67(660):e460-e466. doi: 10.3399/bjgp17X691349. Epub 2017 Jun 5.

  PMID: 28583943 BACKGROUND

MeSH Terms

Conditions

Neoplasms

Study Officials

• Romi A Carriere, MPH

  University of Aberdeen

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 24, 2019
• First Posted: February 11, 2019
• Study Start: March 3, 2019
• Primary Completion: March 3, 2020
• Study Completion: March 3, 2020
• Last Updated: February 18, 2021

Record last verified: 2021-02

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)