What does this research mean for the field?

For cancer patients, rural versus urban geography primarily influences the physical, financial, and emotional burden of accessing care rather than the perceived quality of the care itself. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research investigates how the location of residence influences cancer care experiences among patients in Northeast Scotland.

June 6, 2026Open Access

“You lose a day for every appointment”: A qualitative study of how rural versus urban residence shapes cancer care experiences in Northeast Scotland

RCRomi CarriereUniversity of Aberdeen RARosalind AdamUniversity of Aberdeen LSLeslie SamuelUniversity of Aberdeen

Key Points

This research investigates how the location of residence influences cancer care experiences among patients in Northeast Scotland.
Conducted semi-structured interviews with 20 adults diagnosed with cancer 6-12 months prior to the study.
Participants included those from rural and urban settings attending oncology follow-up at Aberdeen Royal Infirmary.
Analyzed qualitative data using the Framework Method, focusing on themes related to distance, access, and local support.
Participants highlighted that travel distance increased fatigue and uncertainty, impacting their care experience.
Trust in cancer services remained high despite variable access to general practitioner (GP) services across geographies.
Rural lifestyles had benefits, but travel burdens often negated these, particularly for men relying on partners for support.

Abstract

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.

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