Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Equitable Cancer Outcomes across Rural and Remote Australia (ECORRA): A national mixed-methods study on determinants influencing time to cancer diagnosis and treatment (126551)

Anna Ugalde 1 , Anna Chapman 1 , Amy Anderson 1 , Charlene Wright 1 , Fiona Crawford-Williams 2 , Helena Rodi 1 , Hannah Jongebloed 1 , Sharina Riva 1 , Anna Wong Shee 1 3 , Camille Short 4 , Nicolas Hart 5 , Kate Gunn 6 , Rebecca Bergin 1 , Anna Boltong 7 , Joel Rhee 8 , Deme Karikios 9 , Nicole Kiss 1 , Lucy Leigh 10 , Lan Gao 1 , Drew Aras 11 12 , Skye Marshall 1 , Serene Yoong 1
  1. Deakin University, Burwood, Vic
  2. Flinders University, Adelaide, SA
  3. Grampians Health, Ballarat
  4. University of Melbourne, Parkville
  5. University of Technology Sydney, Sydney
  6. University of South Australia, Adelaide
  7. Monash University, Clayton
  8. University of New South Wales, Sydney
  9. University of Sydney, Sydney
  10. Hunter Medical Research Institute, Newcastle
  11. Western Alliance, Ballarat
  12. Western Alliance, Geelong

Objective/purpose: Australians living in rural and remote areas experience poorer outcomes compared to those in urban areas. To address this inequity, the ECORRA trial aims to develop, codesign, and embed an implementation package to support rural and remote healthcare services in aligning with the Optimal Care Pathways (OCPs). This study describes the determinants influencing time to cancer diagnosis and treatment commencement in rural and remote communities.  

Procedures: A mixed-methods study was conducted, comprising a national survey and semi-structured interviews. The Theoretical Domains Framework (TDF) guided data collection with healthcare professionals (clinicians and managers involved in cancer care), while Levesque’s framework for healthcare access guided consumer interviews (adults with lived experience of cancer). Eligible participants had provided or received cancer care in rural or remote Australia. Purposive sampling was undertaken, guided by ECORRA trial stakeholders and partners, and broader social media advertising. Quantitative data were analysed descriptively, and informed qualitative thematic analysis and mapping to relevant TDF or Levesque domains.  

Results: Nationally, 85 people were recruited, including 67 professionals (70% female; 39% medical;42% nursing), and 18 consumers (78% female). Among professionals, 63% reported good or excellent awareness of the OCPs and felt equipped to deliver OCP-concordant care, despite 63% never receiving specific training. While all professionals agreed that OCP adherence improves outcomes, fewer felt capable of meeting diagnostic and treatment timelines. Professional interviews highlighted system-level and resource barriers, including limited diagnostic and treatment equipment, specialist shortages, and poor interoperability of IT systems. Consumers highlighted service scarcity, long travel distances, financial burdens, and challenges navigating complex health systems as major access barriers.

Conclusions: This study identified key determinants affecting the timeliness of cancer diagnosis and treatment commencement across rural and remote settings. Findings will inform the design of theory-driven, equity-focused implementation strategies to support delivery of optimal cancer care across Australia.