Annals of Hematology

, Volume 97, Issue 7, pp 1283–1292 | Cite as

Unmet supportive care needs of haematological cancer survivors: rural versus urban residents

  • Flora TzelepisEmail author
  • Christine L. Paul
  • Robert W. Sanson-Fisher
  • H. Sharon Campbell
  • Kenneth Bradstock
  • Mariko L. Carey
  • Anna Williamson
Original Article


Due to fewer cancer services in rural locations, rural survivors may have unique unmet needs compared to urban survivors. This study compared among rural and urban haematological cancer survivors the most common “high/very high” unmet supportive care needs and the unmet need scores for five domains (information, financial concerns, access and continuity of care, relationships and emotional health). Survivors’ socio-demographics, rurality, cancer history and psychological factors associated with each unmet need domain were also explored. A total of 1511 haematological cancer survivors were recruited from five Australian state cancer registries and 1417 (1145 urban, 272 rural) allowed extraction of their residential postcode from registry records. A questionnaire that contained the Survivor Unmet Needs Survey was mailed to survivors. Dealing with feeling tired was the most common “high/very high” unmet need for rural (15.2%) and urban (15.5%) survivors. The emotional health domain had the highest mean unmet need score for rural and urban survivors. Rurality was associated with a decreased unmet emotional health domain score whereas travelling for more than 1 h to treatment was associated with increased unmet financial concerns and unmet access and continuity of care. Depression, anxiety and stress were associated with increased unmet need scores for all five domains. Unmet need domain scores generally did not differ by rurality. Travelling for more than 1 h to treatment was associated with increased unmet need scores on two domains. Telemedicine and increased financial assistance with travel and accommodation may help those travelling long distances for treatment.


Haematological cancer Rural Supportive care Unmet needs Urban 



The authors are grateful to the cancer registry staff for assistance with case recruitment; Ms. Sandra Dowley and Miss Clara Davis for data entry; Miss Ally Logatchova, Dr. Emilie Cameron, Miss Hannah Small and Miss Lara Ryan for assistance with data cleaning; and Joseph Hanna and Christopher Oldmeadow for statistical support.


This work was supported by a grant awarded through the Priority-driven Collaborative Cancer Research Scheme and co-funded by beyond blue and the Australian Government through Cancer Australia (No. 569290). The University of Newcastle and Hunter Medical Research Institute provided infrastructure support. FT was supported by a Leukaemia Foundation of Australia and Cure Cancer Australia Foundation Post-Doctoral Research Fellowship. CLP was supported by an HMRI Fellowship and an NHMRC Career Development Fellowship. MLC is supported by a NHMRC TRIP Fellowship.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Priority Research Centre for Health BehaviourUniversity of Newcastle and Hunter Medical Research InstituteCallaghanAustralia
  2. 2.Propel Centre for Population Health ImpactUniversity of WaterlooWaterlooCanada
  3. 3.Sydney Medical School, WestmeadUniversity of SydneySydneyAustralia
  4. 4.Leukaemia Foundation of AustraliaBrisbaneAustralia

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