Geographic disparities in access to cancer care: do patients in outlying areas talk about their access problems to their general practitioners and medical oncologists and how does that impact on the choice of chemotherapy?

Abstract

Geographic disparities in access to cancer care have been reported for several countries. The distance between the place of residence and the cancer care centre can be one cause of these disparities. Solutions to surmount the barriers can be found if patients talk about this to their care professionals. We investigated whether patients in Valais talk with their physicians about difficulties to access cancer care. We interviewed five general practitioners and five medical oncologists in Valais with semi-structured interviews to identify difficulties patients are talking about. Medical oncologists were also interviewed on their habits to adapt chemotherapy to access problems of their patients. Cancer patients in Valais do talk about their access problems. Medical oncologists in Valais do take access problems into account when discussing therapeutic options with the patients and use the scope they have within their therapeutic options. In Valais the family of cancer patients play an important role in access to cancer care. Special offers are in place when social support is insufficient. Whether some socio-economic minorities do not use the solutions in place cannot be answered and should be investigated in further studies.