Bergin RJ, et al. - Authors gauged the time to diagnosis and treatment for rural and urban patients with colorectal or breast cancer in Victoria, Australia. Findings suggested an association of rural residence with longer total intervals for colorectal but not breast cancer; with most disparities postpresentation. Colorectal cancer rural–urban disparities may be reduced with the interventions targeting time from presentation to diagnosis.

Methods

• Researcghers conducted the population-based surveys (2013–2014) of patients (aged ≥40, approached within 6 months of diagnosis), primary care physicians (PCPs), and collected the specialists as part of the International Cancer Benchmarking Partnership, Module 4.
• They examined 6 intervals: patient (symptom to presentation), primary care (presentation to referral), diagnostic (presentation/screening to diagnosis), treatment (diagnosis to treatment), health system (presentation to treatment), and total interval (symptom/screening to treatment).
• They compared the rural and urban intervals using quantile regression including age, sex, insurance, and socioeconomic status.

Results

• As per data, 433 colorectal (48% rural) and 489 breast (42% rural) patients, 621 PCPs, and 370 specialists participated.
• Significantly longer total intervals at the 50th [18 days longer, 95% confidence interval (CI): 9–27], 75th (53, 95% CI: 47–59), and 90th percentiles (44, 95% CI: 40–48) were seen in patients with symptomatic colorectal cancer from rural areas vs urban patients.
• Findings suggested that these patients also had longer diagnostic and health system intervals (6–85 days longer).
• They noted similar breast cancer intervals by area of residence, except the patient interval, which was shorter for rural patients with either cancer in the higher percentiles.