Equal care, survival rates for country cancer patients

Country South Australians with colorectal cancer that has spread to other areas of the body are receiving equal surgical care and have the same survival rates as those living in the city, according to new research from the University of Adelaide.

The results of the study, published in the Australian Journal of Rural Health, show that overall, country patients experience no delays in the diagnosis of metastatic colorectal cancer and are living just as long as their city counterparts.

Colorectal cancer is the second most common cancer in Australia, accounting for around 10% of all cancer deaths. While previous studies have suggested poorer survival rates for rural patients, until now no studies have looked at the comparison for patients with cancer that has metastasised through the body.

The Head of the Discipline of Surgery at the University of Adelaide, Professor Guy Maddern, says the findings show the quality of care experienced by country patients in this group is the same as those from the city.

"In the past decade, there have been many new developments in the treatment of metastatic colorectal cancer. This, combined with the centralisation of surgical services, appears to have generated significant benefits for rural patients," says Professor Maddern, who is based at The Queen Elizabeth Hospital.

Of the more than 1300 patients studied, 68% had experienced a spread of their cancer to the liver, with 25% having cancer spread to the lungs. The average survival rate for all patients from the date of diagnosis was 20 months.

"Overall, there was no evidence of a disparity in diagnosis, surgical treatment or survival of patients based on geographic region. The shift towards centralisation of surgical services in South Australia appears to have improved the uptake of liver surgery even in the most remote communities, and this has had a positive impact on both short and long-term survival rates," Professor Maddern says.

Professor Maddern says one issue raised by the findings of the study is that not enough older people are undergoing surgery for their metastasised cancer.

"Patients aged 60 years and over are less likely to undergo liver surgery, and those aged over 80 are much less likely to have surgery, despite evidence showing significant survival outcomes in both elderly and younger patients," Professor Maddern says.

"Our recommendation is that elderly patients should seriously consider surgery for their metastatic cancer. More work would also need to be done to better understand the barriers to elderly patients accessing - or being encouraged to access - appropriate surgical services."