Survivorship needs and experiences of survivors of head and neck cancer in rural Australia: a qualitative study

Aim: Head and neck cancer (HNC) survivors experience complex survivorship needs compared to other cancer types. This is exacerbated for people living in regional and remote (rural) areas of Australia, who experience poorer outcomes, higher physical and psychological needs, and poorer quality of life compared to their metropolitan counterparts. Little is known about the general survivorship experiences of rural HNC survivors in New South Wales (NSW), Australia. This study aims to explore the general survivorship experiences of people living with HNC in rural areas of NSW, Australia. Methods: HNC survivors living in rural NSW were recruited, and semi-structured interviews were conducted to explore their general survivorship experiences. The interviews were recorded, transcribed, and analyzed using a qualitative thematic analysis approach until saturation of themes was reached. Results: Semi-structured interviews were conducted with 17 participants, with a mean age of 65 years. The most common diagnoses were oral cavity (41%) and oropharyngeal cancers (29%). Six key themes emerged around general survivorship experiences among participants: 1) financial impacts, 2) physical effects, 3) psychosocial effects, 4) clinical management, 5) information and support needs, and 6) access. Conclusions: Rural cancer survivors face unique survivorship concerns, exacerbated by living further from specialist care. The unmet needs of people living in rural areas include financial reimbursement, psychosocial services and support, and access to survivorship care closer to home. Understanding cancer survivors' experiences throughout the care journey can identify unmet needs. By recognizing these needs, they can be more readily addressed by government policy and other interventions.