Objectives/purpose
Rural and remote Australians experience delays to cancer diagnosis and treatment of 18-53 days, compromising survival. The healthcare system often defaults to creating new programs rather than adapting and implementing existing ones. This study aims to identify evidence-based initiatives developed in the Australian healthcare system that could optimise time to cancer diagnosis, multidisciplinary meeting (MDM) conduct, or time to cancer treatment commencement for Australians living in rural and remote areas. This approach aligns with key national strategies which emphasise building on existing investments and optimising current systems.
Sample and setting
An environmental scan was conducted using abstracts from the Clinical Oncology Society of Australia (COSA) Annual Scientific Meetings between 2022-2024.
Procedures
Abstracts were screened focusing on initiatives with potential to affect time to diagnosis, MDM conduct, and time to treatment commencement. Data extracted included intervention type, target population, outcomes, and rural applicability factors.
Results
Of 446 abstracts, 104 were identified as eligible. Abstracts described initiatives with potential to affect time to diagnosis (n=42), MDM conduct (n=32), and time to treatment commencement (n=95). Some initiatives had potential to address multiple outcomes; all three outcomes (n=16), time to diagnosis and MDM conduct (n=24), and MDM conduct and time to treatment commencement (n=12). Promising initiatives with rural adaptation potential included telehealth consultations, teletrials, online training modules, survivorship programs, nurse-led care models, and clinical decision-support toolkits. Key enablers for rural translation were telehealth, metropolitan-regional health service partnerships, and targeted programs addressing disparities in care and clinical trial access.
Conclusion and clinical implications
This catalogue of transferable, evidence-based initiatives provides a foundation to address rural cancer care disparities by adapting proven interventions and reducing time-sensitive delays. Future implementation research will assess feasibility in specific rural contexts and develop tailored adaptation strategies to support rural cancer services to identify and sustainably embed appropriate initiatives.