Barriers to Early Presentation amongst Rural Residents Experiencing Symptoms of Colorectal Cancer: A Qualitative Interview Study

Christina Dobson* (Corresponding Author), Jennifer Deane, Sara Macdonald, Peter Murchie, Christina Ellwood, Lorraine Angell, Greg Rubin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Downloads (Pure)


Rural cancer inequalities are evident internationally, with rural cancer patients 5% less likely to survive than their urban counterparts. There is evidence to suggest that diagnostic delays prior to entry into secondary care may be contributing to these poorer rural cancer outcomes. This study explores the symptom appraisal and help-seeking decision-making of people experiencing symptoms of colorectal cancer in rural areas of England. Patients were randomly invited from 4 rural practices, serving diverse communities. Semi-structured interviews were undertaken with 40 people who had experienced symptoms of colorectal cancer in the preceding 8 weeks. Four key themes were identified as influential in participants’ willingness and timeliness of consultation: a desire to rule out cancer (facilitator of help-seeking); stoicism and self-reliance (barrier to help-seeking); time scarcity (barrier to help-seeking); and GP/patient relationship (barrier or facilitator, depending on perceived strength of the relationship). Self-employed, and “native” rural residents most commonly reported experiencing time scarcity and poor GP/patient relationships as a barrier to (re-)consultation. Targeted, active safety-netting approaches, and increased continuity of care, may be particularly beneficial to expedite timely diagnoses and minimise cancer inequalities for rural populations.
Original languageEnglish
Article number274
Number of pages12
Issue number1
Publication statusPublished - 31 Dec 2022

Data Availability Statement

Supplementary Materials: The following supporting information can be downloaded at:, Table S1: Participant Characteristics; Interview Topic Guide.

Data Availability Statement: As per ethical approvals for this study, participants were not asked to provide consent for their interview data to be shared beyond the research team, due to the personal and potentially sensitive nature of the interview topics. As such, the interview data set is not freely available.


  • colorectal cancer
  • rurality
  • early diagnosis
  • help-seeking
  • cancer inequalities
  • diagnostic delays


Dive into the research topics of 'Barriers to Early Presentation amongst Rural Residents Experiencing Symptoms of Colorectal Cancer: A Qualitative Interview Study'. Together they form a unique fingerprint.

Cite this