Improving rural cancer outcomes (IRCO)

Improving Rural Cancer Outcomes (IRCO)

Conference presentations:

Union for International Cancer Control conference:
                Melbourne 2014
                Paris 2016
Cancer in Primary Care International Network
                Aarhus 2015
Cancer Nurses Society of Australia
                Perth 2015
Society for Academic Primary Care
                Dublin 2016
Cancer Research Early Diagnosis Conference
                London 2017
Primary Care Cancer Collaborative Clinical Trials Group (PC4) Symposium
                Melbourne 2017
Cancer Council Victoria Behavioural Research in Cancer Control
                Melbourne 2017

It is not widely appreciated how seriously the “Tyranny of distance” affects people with cancer.   Mortality rate for rural populations is about 30% higher than for urban people, ranging from small elevation to 70% higher mortality in some remote regions.

A major project for over two years, under two top medical  researchers, Prof D’Arcy Holman and Prof Jon Emory, both of UWA,  seeks the actual causes for this gap.    Over 500 patient case records were studied, with their consent,  and the treatment path of each compared to the ideal.   Interviews were conducted to establish where delays happened and why, where there were cost or travel barriers, or simple misunderstandings.  Time to see the first doctor, time to diagnosis, time to see the cancer team, hospital delays and every other possible issue has been listed.

The frequency and seriousness of each issue created a list of priorities.  The team then developed strategies for improvement.  These involved the public, doctors, availability of information, access to consultants and even the functioning of the specialist hospitals, their cancer teams and how they ensure treatment continues after hospital.

The research  tested whether these strategies  work in the real world.  Testing was at limited sites for cost reasons. The Val Lishman Health Research Foundation Inc has taken responsibility for one part of the strategy. It funded and managed an evaluation of a public campaign, 18 months after the intervention.  The delay was because durability of effect must be clear if it is be funded for wider regional Australia.

The research took place in two phases,  Phase One; developing measuring tools for changes in  understanding and attitude of the public about cancer.  One year.    In the second year (Phase Two),  the interviewers used the tools to compare areas which had the campaign with areas that had no campaign.

Cost $50,000 annually for two years,commenced early 2013.  This was funded by the generous Jack Denning Bequest, made in 2009.
Work commenced at the beginning of 2013.