We need improved primary care, access to expert multidisciplinary services, and appropriate coordination of the two
More than a third of Australians live outside major cities, with 3% living in remote or very remote areas.1 The health disadvantage of rural and remote Australians is well documented, and includes poorer survival after a diagnosis of cancer.2 Both more advanced cancer at diagnosis and poorer treatment appear to contribute.3 Documented instances of poorer cancer care in rural and remote Australia, though not necessarily all with survival implications, include less “state of the art” diagnosis, staging and treatment of prostate cancer;4 less breast-conserving surgery for breast cancer;5 and an apparently lower probability of completing treatment when referred for radiotherapy for rectal cancer.6 Surprisingly, there appears to be little difference in women’s use of breast and cervical screening by area of residence.7
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- 1 Northern Rivers University Department of Rural Health, University of Sydney, Lismore, NSW.
- 2 School of Public Health, University of Sydney, Sydney, NSW.
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