Time from diagnosis to treatment: Are rural cancer patients receiving optimal care in Australia?

Purpose To examine the prevalence and characteristics of rural cancer patients in Queensland, Australia, who experienced a delay in starting treatment based on the Optimal Care Pathways (OCPs). Methods A cross-sectional analysis was conducted with 640 adults who accessed Cancer Council Queensland subsidised accommodation while receiving cancer care in a major city. Treatment delay was defined as a diagnosis-to-treatment interval exceeding OCP recommendations. Results The median time from diagnosis to treatment was 4.4 weeks (interquartile range: 2.1–8.9 weeks). Of the 494 participants whose data were assessable against OCPs, 199 (40%) experienced a treatment delay. Delay was not associated with age, sex, geographic remoteness, comorbidities, or treatment modality. Participants without private health insurance had higher odds of delay compared to those with insurance (adjusted odds ratio [aOR] = 1.68, 95% confidence interval [CI] = 1.02–2.78), and participants with breast (aOR = 0.32, 95% CI = 0.14–0.74) or skin (aOR = 0.23, 95% CI = 0.09–0.61) cancers had lower odds of delay than those with other cancer types. Conclusion Two in five rural cancer patients did not commence treatment within recommended timeframes. Strategies are needed to support the implementation of the Optimal Care Pathways in Australian health services and address inequities related to health insurance and cancer type.