• Hilary L Martin, Kanako Ohara, Wee Chin, Andrew Davidson, Evan Bayliss, Andrew Redfern, and Muhammad Adnan Khattak.
• Department of Medical Oncology, Royal Perth Hospital, University of Western Australia, Perth, Western Australia, Australia.
• Aust J Rural Health. 2015 Oct 1; 23 (5): 302-8.

ObjectiveTo investigate whether any survival differences existed between advanced cancer patients treated in metropolitan Perth and those treated in regional Western Australia (WA).DesignRetrospective study.SettingAdvanced cancer patients treated through medical oncology clinics at Royal Perth Hospital and regional cancer centres (Kalgoorlie, Albany, Geraldton and Northam).ParticipantsPatients diagnosed with advanced melanoma, breast, colorectal, gastro-oesophageal, prostate, lung and pancreatic cancers between 1 January 2007 and 31 December 2011.InterventionsNil.Main Outcome MeasureMedian survival.ResultsData were available for 1581 patients with 75% living in a metropolitan setting and 25% in rural WA. Median overall survival was 8.3 months for metropolitan patients and 7.6 months for regional patients (P = 0.06, HR 0.89; 95% CI, 0.78-1.01). There was no statistically significant difference in median survival for different tumour types except pancreatic cancer: breast 22.1 months versus 21.3 months, colorectal 13.1 months versus 16.4 months, lung 5.1 months versus 3.1 months, upper GI 5.6 months versus 7.2 months, pancreatic 4.5 months versus 3 months (P = 0.02, HR 0.57; 95% CI, 0.32-0.99), melanoma 10.4 months versus 10.5 months, prostate 28.6 months versus 15.3 months. Rural cancer patients with breast and pancreatic cancers received fewer lines of anti-cancer therapy compared to metropolitan patients. The three-year survival rates for metropolitan compared to rural breast cancer patients were 34 and 23%, respectively (not statistically significant).ConclusionOur findings suggest a trend towards inferior survival for regional cancer patients in WA compared with metropolitan-based patients.© 2015 National Rural Health Alliance Inc.

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