Cancer survival rates lower for patients living on Northern Isles, study finds

Cancer patients living on Scottish islands were more likely to die within a year of diagnosis than those on the mainland, according to a study.

The research, which looked at patients in north-east Scotland and the Northern Isles, found those who live further from cancer treatment centres are likely to receive different care and experience worse outcomes than those who live closer.

Researchers found patients living in Orkney and Shetland spent more time in hospital and attended fewer oncology outpatient appointments.

This was associated with a higher risk of death within a year of diagnosis compared to their counterparts on the mainland.

Patients on the mainland who had long travelling times also spent more time in hospital but had more oncology outpatient appointments, and in their case, there was no increased risk of death within a year of diagnosis, the research found.

The University of Aberdeen study looked at data from more than 17,300 patients diagnosed with one of eight cancer types over 10 years, from 2007 to 2017.

Professor Peter Murchie, clinical chair in academic primary care at the university, who led the research alongside colleagues from NHS Grampian, said: “It is essential that we continue to ensure equitable cancer care across all of Scotland’s geography.

“This research is a good step forward in beginning to unpick the complex mechanisms underlying poorer outcomes for our rural cancer patients.”

The study also found that when patients who lived remotely had an emergency cancer admission, they were more likely to die within the first year following diagnosis.

However, longer travelling times or living on an island did not increase the likelihood of emergency admission for cancer or affect the length of time to first emergency cancer admission.

The patients studied lived in the NHS Grampian, NHS Orkney or NHS Shetland health board areas. The region is served by a single specialist cancer treatment centre based at Aberdeen Royal Infirmary.

Island patients made up 8% of those in the study.

Further analysis of factors that may influence survival found it cannot be explained by age, type of treatment, socioeconomic status, non-cancer related co-morbidities or metastatic cancer.

Petri dish
The research involved patients in north-east Scotland, Orkney and Shetland (PA)

Researchers did find a trend towards a positive effect of the involvement of the oncology team where more oncology outpatient appointments reduced the risk.

The team is now working to establish whether there is a difference in the treatment choices made by people living in the islands.

The study, which was funded by the NHS Grampian Charity and published in the journal Health & Place, calls for “better configuration of cancer services” across Scotland to address disparities in care.

Dr Kirsty Brightwell, NHS Shetland medical director, said: “This study looks at data from 2007-2017 and a lot has changed since then, not least of all the changes put in place during the pandemic.

“We continue to work closely with colleagues in NHS Grampian to improve services and deliver as much as we can as close to people’s homes as possible whilst maintaining the quality of their experience and outcomes.”

Dr Louise Wilson, director of public health at NHS Orkney, said: “Our cancer care is delivered in partnership with the specialists in NHS Grampian and supporting patients to make the best treatment choice for their situation is important.

“More therapies are becoming available locally and we will work with NHS Grampian to get the best possible outcomes for our patients.”