Evidence map›Paper›PMID 28926528›Full record

Trial reportBritish journal of cancer2017

The Improving Rural Cancer Outcomes Trial: a cluster-randomised controlled trial of a complex intervention to reduce time to diagnosis in rural cancer patients in Western Australia.

Jon D Emery, Victoria Gray, Fiona M Walter, Shelley Cheetham, Emma J Croager, Terry Slevin, Christobel Saunders, Timothy Threlfall, Kirsten Auret, Anna K Nowak and 3 more

Erratum issuedOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in British journal of cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 24 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 4 pooled it
1.6field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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  7. Educational Interventions to Reduce Cancer Diagnostic Delays in Primary Care: A Scoping Review.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026
    Review
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  13. Hidden systems in primary care cancer detection: an embedded qualitative intervention development study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024
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  20. Approaches to diagnosing cancer earlier in general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 2 countries.

Jon D EmeryDepartment of General Practice and The Centre for Cancer Research, The University of Melbourne, Melbourne, VIC, Australia.
Victoria GraySchool of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Crawley, WA, Australia.
Fiona M WalterSchool of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Crawley, WA, Australia.
Shelley CheethamSchool of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Crawley, WA, Australia.
Emma J CroagerEducation & Research Division, Cancer Council Western Australia; School of Psychology and Speech Pathology, Curtin University, Bentley, WA, Australia.
Terry SlevinEducation & Research Division, Cancer Council Western Australia; School of Psychology and Speech Pathology, Curtin University, Bentley, WA, Australia.
Christobel SaundersSchool of Surgery, The University of Western Australia, Crawley, WA, Australia.
Timothy ThrelfallWestern Australia Cancer Registry, The Department of Health of Western Australia, Perth, WA, Australia.
Kirsten AuretRural Clinical School of Western Australia, The University of Western Australia, Albany, WA, Australia.
Anna K NowakSchool of Medicine, The University of Western Australia, Crawley, WA, Australia.
Elizabeth GeelhoedSchool of Population Health, The University of Western Australia, Crawley, WA, Australia.
Max BulsaraInstitute for Health Research, University of Notre Dame, Freemantle, WA, Australia.
C D'Arcy J HolmanSchool of Population Health, The University of Western Australia, Crawley, WA, Australia.
University of Western Australia · AUCancer Council Western Australia · AUCurtin University · AUGovernment of Western Australia Department of Health · AUSir Charles Gairdner Hospital · AUThe University of Notre Dame Australia · AUUniversity of Cambridge · GBUniversity of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRural Australians have poorer survival for most common cancers, due partially to later diagnosis. Internationally, several initiatives to improve cancer outcomes have focused on earlier presentation to healthcare and timely diagnosis. We aimed to measure the effect of community-based symptom awareness and general practice-based educational interventions on the time to diagnosis in rural patients presenting with breast, prostate, colorectal or lung cancer in Western Australia.

methods2 × 2 factorial cluster randomised controlled trial. Community Intervention: cancer symptom awareness campaign tailored for rural Australians. GP intervention: resource card with symptom risk assessment charts and local cancer referral pathways implemented through multiple academic detailing visits. Trial Area A received the community symptom awareness and Trial Area B acted as the community campaign control region. Within both Trial Areas general practices were randomised to the GP intervention or control. PRIMARY OUTCOME: total diagnostic interval (TDI).

results1358 people with incident breast, prostate, colorectal or lung cancer were recruited. There were no significant differences in the median or ln mean TDI at either intervention level (community intervention vs control: median TDI 107.5 vs 92 days; ln mean difference 0.08 95% CI -0.06-0.23 P=0.27; GP intervention vs control: median TDI 97 vs 96.5 days; ln mean difference 0.004 95% CI -0.18-0.19 P=0.99). There were no significant differences in the TDI when analysed by factorial design, tumour group or sub-intervals of the TDI.

conclusionsThis is the largest trial to test the effect of community campaign or GP interventions on timeliness of cancer diagnosis. We found no effect of either intervention. This may reflect limited dose of the interventions, or the limited duration of follow-up. Alternatively, these interventions do not have a measurable effect on time to cancer diagnosis.

Indexed as

Early Detection of CancerEducation, MedicalFemaleGeneral PractitionersHumansMaleNeoplasmsPatient Education as TopicRural PopulationWestern Australia

Identifiers

PMID28926528
PMCPMC5680459
OpenAlexW2755839523

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.