Higher rural cancer deaths blamed on lack of access to care

Research has established that rural cancer patients have worse outcomes than their urban counterparts, with 180.4 deaths per 100,000 versus 157.8 cancer deaths in urban areas. Some have posited that the disparity arises from factors such as health literacy, socioeconomic status, or poor lifestyle choices. But a study published in the Journal of the American Medical Association found that the biggest problem is lack of access to medical care.

The study looked at nearly 37,000 cancer patients from across the country enrolled in clinical trials over 26 years, and found that the disparity all but vanished when rural and urban patients were enrolled in the same trials. "If rural and urban patients with cancer receiving similar care also have similar outcomes, then a reasonable inference is that the best means by which to improve outcomes for rural patients with cancer may be to improve their access to quality care," the researchers wrote.

The researchers made five recommendations for physician leaders and health-care organizations to help close the mortality gap between rural and urban cancer patients:

• Improve access to affordable health insurance
• Expand access to screening and prevention tools
• Boost access to oncology specialists
• Increase transportation resources for rural patients who travel long distances to access quality care
• Adopt innovation care networks to give rural patients access to new treatments and clinical trials

The researchers also said the National Cancer Institute's National Community Oncology Research Program could serve as a helpful model for other organizations trying to increase rural access to clinical trials, Chris Cheney reports for HealthLeaders.