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The Challenges of Cancer Care in Rural Communities

July 01, 2019

As part of its efforts to understand and address cancer health disparities, the American Society of Clinical Oncology (ASCO) examined the cancer incidence and mortality in urban and rural areas. 

According to the Centers for Disease Control and Prevention’s (CDC) 2017 analysis, the overall age-adjusted incidence of cancer was lower in rural areas than urban areas, but rural areas had higher cancer death rates:

  • Based on data reported for 2011–2015, rural counties had average mortality rates of 180 deaths per 100,000 people a year, compared with 158 deaths per 100,000 in metropolitan counties 
  • Based on data reported for 2004–2015, differences in rural and urban mortality rates grew wider over time

This widening gap is striking given the improvements in treatment and outcomes for many types of cancer. Earlier this year, the CDC released updated cancer statistics showing that overall cancer death rates continue to decline in the U.S. 

Findings from ASCO’s State of Cancer Care in America 2017 Report and 2018 National Cancer Opinion Survey point to differences in access to care that contribute to rural disparities, including:

  • More than 59 million Americans (19%) live in rural areas, but only 6 percent of hematologists and oncologists have at least one rural practice location
  • Rural areas have one oncologist per 100,000 residents, compared with five oncologists per 100,000 in urban areas 
  • Rural cancer patients typically spend 66 percent more time traveling each way to treatment than those who live in more urban areas
  • Four in ten rural Americans (40%) who have or had cancer say there aren’t enough doctors specializing in cancer care near their homes, compared to 22 percent of urban and suburban patients who say the same

In Pennsylvania, 48 out of 67 counties are considered rural, and their residents face similar health care challenges as those in other rural areas around the country. HAP continues to support access to care for rural Pennsylvanians through:

  • Increases in the number of trained and licensed allied health professionals able to provide health care in rural communities
  • Reductions in reporting burdens and revisions to quality measures to ensure they are outcomes-based and meaningful to rural providers and patients  
  • Advances in telehealth and removal of barriers to remote care such as reimbursement, cross-state licensure issues, and administrative and financial burdens
  • Support for state and federal opioid strategies, given the disproportionate impact the opioid epidemic is having on rural communities
  • Promotion of patient and family engagement programs and stronger patient-provider relationships

For additional information about HAP’s rural advocacy efforts, contact Kate Slatt, senior director, innovative payment and care delivery.
 

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