Factors influencing the speed of cancer diagnosis in rural Western Australia: A General Practice perspective

Introduction. The speed of diagnosis impacts on prognosis and survival in all types of cancer. In most cases survival and prognosis are significantly worse in rural and remote Australian populations who have less access to diagnostic and therapeutic services than metropolitan communities in this cou...

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Main Authors: Jiwa, Moyez, Halkett, Georgia, Aoun, Samar, Arnet, Hayley, Smith, Marthe, Pilkington, M., McMullen, C.
Format: Journal Article
Language:English
Published: BioMed Central Ltd. 2007
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/86689
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author Jiwa, Moyez
Halkett, Georgia
Aoun, Samar
Arnet, Hayley
Smith, Marthe
Pilkington, M.
McMullen, C.
author_facet Jiwa, Moyez
Halkett, Georgia
Aoun, Samar
Arnet, Hayley
Smith, Marthe
Pilkington, M.
McMullen, C.
author_sort Jiwa, Moyez
building Curtin Institutional Repository
collection Online Access
description Introduction. The speed of diagnosis impacts on prognosis and survival in all types of cancer. In most cases survival and prognosis are significantly worse in rural and remote Australian populations who have less access to diagnostic and therapeutic services than metropolitan communities in this country. Research suggests that in general delays in diagnosis were a factor of misdiagnosis, the confounding effect of existing conditions and delayed or misleading investigation of symptoms. The aim of this study is to further explore the factors that impact on the speed of diagnosis in rural Western Australia with direct reference to General Practitioners (GPs) working in this setting. Methods. The methodology consisted of a structured discussion of specific cases. GPs based in two rural locations in Western Australia were asked to identify up to eight clinical cases for discussion. A diversity of cases was requested encompassing those with timely and delayed diagnosis of cancer. Focus groups were held with the practitioners to identify which factors under six headings delayed or facilitated the diagnosis in each case. A structured summary of the discussion was relayed to a wider group of GPs to seek additional views or comments on specific factors that impact on the speed of cancer diagnosis in rural and remote locations in Australia. Results. A number of factors affecting the speed of diagnosis were identified: the demographic shift towards a frailer and older population, presenting with multiple and complex diseases, increases the challenge to identify early cancer symptoms; seasonal and demanding work patterns leading to procrastination in presenting for medical care; unhelpful scheduling of specialist appointments; and the varying impact of informal networks and social relationships. Conclusion. Within the limitations of this study we have generated a number of hypotheses that require formal evaluation: (1) GPs working within informal professional and social networks are better informed about their patients' health needs and have an advantage in making early diagnosis; (2) Despite the other differences in the population characteristics decentralising services would improve the prospect for timely diagnosis; and (3) Careful coordination of specialist appointments would improve the speed of diagnosis for rural patients. © 2007 Jiwa et al; licensee BioMed Central Ltd.
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spelling curtin-20.500.11937-866892021-12-06T07:28:33Z Factors influencing the speed of cancer diagnosis in rural Western Australia: A General Practice perspective Jiwa, Moyez Halkett, Georgia Aoun, Samar Arnet, Hayley Smith, Marthe Pilkington, M. McMullen, C. Science & Technology Life Sciences & Biomedicine Primary Health Care Medicine, General & Internal General & Internal Medicine COLORECTAL-CANCER CARE DELAY Introduction. The speed of diagnosis impacts on prognosis and survival in all types of cancer. In most cases survival and prognosis are significantly worse in rural and remote Australian populations who have less access to diagnostic and therapeutic services than metropolitan communities in this country. Research suggests that in general delays in diagnosis were a factor of misdiagnosis, the confounding effect of existing conditions and delayed or misleading investigation of symptoms. The aim of this study is to further explore the factors that impact on the speed of diagnosis in rural Western Australia with direct reference to General Practitioners (GPs) working in this setting. Methods. The methodology consisted of a structured discussion of specific cases. GPs based in two rural locations in Western Australia were asked to identify up to eight clinical cases for discussion. A diversity of cases was requested encompassing those with timely and delayed diagnosis of cancer. Focus groups were held with the practitioners to identify which factors under six headings delayed or facilitated the diagnosis in each case. A structured summary of the discussion was relayed to a wider group of GPs to seek additional views or comments on specific factors that impact on the speed of cancer diagnosis in rural and remote locations in Australia. Results. A number of factors affecting the speed of diagnosis were identified: the demographic shift towards a frailer and older population, presenting with multiple and complex diseases, increases the challenge to identify early cancer symptoms; seasonal and demanding work patterns leading to procrastination in presenting for medical care; unhelpful scheduling of specialist appointments; and the varying impact of informal networks and social relationships. Conclusion. Within the limitations of this study we have generated a number of hypotheses that require formal evaluation: (1) GPs working within informal professional and social networks are better informed about their patients' health needs and have an advantage in making early diagnosis; (2) Despite the other differences in the population characteristics decentralising services would improve the prospect for timely diagnosis; and (3) Careful coordination of specialist appointments would improve the speed of diagnosis for rural patients. © 2007 Jiwa et al; licensee BioMed Central Ltd. 2007 Journal Article http://hdl.handle.net/20.500.11937/86689 10.1186/1471-2296-8-27 English http://creativecommons.org/licenses/by/2.0 BioMed Central Ltd. fulltext
spellingShingle Science & Technology
Life Sciences & Biomedicine
Primary Health Care
Medicine, General & Internal
General & Internal Medicine
COLORECTAL-CANCER
CARE
DELAY
Jiwa, Moyez
Halkett, Georgia
Aoun, Samar
Arnet, Hayley
Smith, Marthe
Pilkington, M.
McMullen, C.
Factors influencing the speed of cancer diagnosis in rural Western Australia: A General Practice perspective
title Factors influencing the speed of cancer diagnosis in rural Western Australia: A General Practice perspective
title_full Factors influencing the speed of cancer diagnosis in rural Western Australia: A General Practice perspective
title_fullStr Factors influencing the speed of cancer diagnosis in rural Western Australia: A General Practice perspective
title_full_unstemmed Factors influencing the speed of cancer diagnosis in rural Western Australia: A General Practice perspective
title_short Factors influencing the speed of cancer diagnosis in rural Western Australia: A General Practice perspective
title_sort factors influencing the speed of cancer diagnosis in rural western australia: a general practice perspective
topic Science & Technology
Life Sciences & Biomedicine
Primary Health Care
Medicine, General & Internal
General & Internal Medicine
COLORECTAL-CANCER
CARE
DELAY
url http://hdl.handle.net/20.500.11937/86689