PURPOSE: Quantitative studies show that rural-dwelling cancer patients experience poorer survival than urban residents, but the mechanisms remain unclear. This study explored how rural versus urban residence shaped cancer care experiences among patients interviewed after primary treatment in Northeast Scotland, including treatment access, follow-up, recovery, and ongoing engagement with services. METHODS: Semi-structured interviews were conducted with adults diagnosed within the previous 6-12 months, post-primary treatment, and attending oncology follow-up at Aberdeen Royal Infirmary. Topic guides were informed by a socioecological model of rural cancer disadvantage. Interviews were audio-recorded, transcribed verbatim, anonymised, and analysed using the Framework Method. Sampling was purposive for geography, age, and sex. Ethical approval was granted by the North of Scotland Research Ethics Committee (REC 19/NS/0032). RESULTS: Twenty participants (mean age 67; 13 men, 7 women; 9 rural, 11 urban) described experiences of colorectal (n = 12), prostate (n = 3), and other cancers (n = 5). Four themes were identified: (1) impact of distance and travel time-travel amplified fatigue, costs, and uncertainty; (2) access, trust, and communication-variable GP access but high trust in the cancer centre; (3) physical and social infrastructure-benefits of improved roads, direct bus routes, and third-sector support; (4) pros and cons of rural life-rural lifestyle benefits often offset travel burdens. Men tended to rely mainly on partners, while women reported broader networks. Cancer type and age intersected with geography to shape burdens such as continence-related travel constraints after prostate surgery. CONCLUSIONS: Geography influenced the burden of accessing rather than the quality of care. Person-centred scheduling, local delivery of peripheral care, transport-aware planning, and collaboration with third-sector providers could mitigate inequities.
Carriere et al. (Thu,) studied this question.