Diagnosing cancer in the bush: a mixed-methods study of symptom appraisal and help-seeking behaviour in people with cancer from rural Western Australia

Abstract

Longer symptom appraisal was observed for colorectal cancer. Participants defined core characteristics of rural Australians as optimism, stoicism and machismo. These features, as well as access to health care, contribute to later presentation of cancer.

Impact of travel time and rurality on presentation and outcomes of symptomatic colorectal cancer: a cross-sectional cohort study in primary care

“…Such ruralurban differences may be driven by social cultural differences in health-seeking behaviour, where the most remote rural patients may be displaying stoicism when seeking help. 3,4,8,26 This may be supported by studies from northern Scotland that found rural patients were more likely to present later, had lower expectations of health care, and may pursue their care less tenaciously.…”

“…3 First, rural populations may be impacted disproportionately by financial constraints and poor accessibility, compounded by the long distances travelled to obtain primary and secondary health care. 4 For example, longer distance to health services has been associated with fewer in-patient admissions, 5 with poorer uptake of cancer diagnosis and treatment, 1,6,7 and with lower survival.…”

“…2 Second, sociocultural factors could manifest as different attitudes or stoicism in rural dwellers, with correspondingly lower rates of primary care consultation and, as a consequence, lower likelihood of GPs being enabled to detect early cancer symptoms. 3,8 Geographical location and considerations of access could also influence GP decision making if they take into account patients' journey to hospital when making referral decisions. 5,9 Acting together, these mechanisms could conspire against rural patients and their GPs, and lead to disproportionately longer diagnostic delays, later-stage presentation, and poorer survival.…”

Lung cancer in rural and remote Aboriginal and Torres Strait Islander communities in Queensland: awareness and identifying health needs in a cultural context

“…13 Over two centuries have passed since the British arrived in Australia or as sometimes referred to as the 'invasion'. 40 Over this time Indigenous Australians were forcibly removed from their lands and separated from their families which resulted in the loss of traditional ways and values. 13,23 Colonisation is seen to have caused most of the adversity faced by Indigenous Australians.…”

“…10 Therefore, we should be aiming to prevent lung cancer by raising awareness of risk factors and increasing patient support to facilitate early diagnosis and treatment. 40 Well rounded health promotion or prevention activities considerate of culture and language can help mitigate fatalistic attitudes and reluctance to seek treatments. 11 Health professionals who have an awareness and understanding of Indigenous Australians' culture are better equipped to provide information on cancer in a culturally sensitive, relevant manner.…”