New research reveals key reasons behind low cancer survival rates in rural Yorkshire

Poor relationships with their GPs and concerns about losing time from work are preventing people in rural areas from seeking help for cancer symptoms, according to new research published in the journal Cancers.

The Newcastle University study, funded by Yorkshire Cancer Research, aimed to discover why people living in rural areas in North Yorkshire are less likely to survive cancer than those living in urban towns and cities¹.

Findings from the study will help improve understanding of how the charity can best serve communities across Yorkshire.

Hundreds of patients at four GP practices in North Yorkshire took part in the research, completing surveys and in-depth interviews.

The study focused on people experiencing symptoms that can be related to bowel cancer. Statistics show that 1 in 2 bowel cancers in Yorkshire are diagnosed at a late stage, when they are less likely to be treated successfully².

Dr Christina Dobson, Senior Research Associate in the Population Health Science Institute at Newcastle University, and lead researcher for the study, said:

“Evidence suggests that people living in rural areas are less likely to survive cancer than those in urban areas. One of the reasons for this is that it takes longer for people in rural areas to be diagnosed with cancer."

"We found that some factors encouraged people to speak to their GP about symptoms quickly, whereas others were likely to cause people to take longer to come forward.”

Four key themes emerged from the study. A desire to rule-out cancer, particularly among people who had a family history of bowel cancer, was the main influence that prompted people to speak to their GP about symptoms early.

However, a tendency among people living in rural communities to want to manage their health independently, combined with a sense of not wanting to ‘waste their GP’s time' with minor problems, meant that they often only visit their doctor after they felt symptoms had become unmanageable.

Longer travel times for those living in rural areas, combined with high levels of self-employment and employment in industries with seasonal work pressures such as farming and tourism, meant that people often delayed visiting their doctor to avoid losing working time and income.

A patient’s relationship with their GP could also affect how likely they were to seek medical advice for bowel cancer symptoms. Those who had a good relationship with their GP were more likely to go to the doctor and return to the doctor if symptoms persisted, changed, or worsened.

People taking part in the study who did not feel they had a good relationship with their GP, often due to the doctor not knowing their personal and medical history, or not feeling listened to during appointments, were less likely to visit their GP or to return when their symptoms worsened.

Dr Dobson continued: “The findings from this study have highlighted the specific factors that prevent people living in rural areas from seeking help for potential symptoms of cancer.

“The findings can now be used to inform strategies to support rural patients in engaging with health care services and encourage them to visit their GP with symptoms earlier, potentially saving lives in the region.”

1 Carriere, R.; Adam, R.; Fielding, S.; Barlas, R.; Ong, Y.; Murchie, P. Rural dwellers are less likely to survive cancer—An international review and meta-analysis. Health Place 2018, 53, 219–227. [Google Scholar] [CrossRef] [PubMed]

2 CancerData - Stage at diagnosis 2019