The Disproportionate Impact of Cancer on Rural Communities
Cancer is the second most common cause of death in the United States. But thanks to new innovations to screen, diagnose and treat cancer, mortality rates have been steadily decreasing across the country. Unfortunately, as a new study by the Grange with data analytics firm Xcenda reveals, this decline has not been experienced equally.
The study finds that compared to urban areas, rural communities have overall higher rates of cancer incidence, late-stage diagnoses, and mortality – and the urban-rural disparity in cancer mortality has been steadily widening over the last decade. Rural areas also generally have lower self-reported rates of preventive screenings for colorectal, breast, and cervical cancer.
Using data from the Centers for Disease Control and Prevention (CDC) researchers at Xcenda aimed to quantify the disparity in cancer burden for people living in rural areas. The researchers also examined disparities in four states: Georgia, South Carolina, Tennessee and Texas – all of which have significant populations living in both rural and urban areas which made for a more straightforward comparison.
Key Findings of the Report
● Nationwide, cancer deaths in rural areas are 14% higher than urban areas and the urban-rural disparity in cancer death rates is getting worse. Nationwide, the disparity in the rate of cancer deaths between rural and urban counties increased between 2011-2015 and 2016-2020, despite the overall cancer death rate decreasing. This national trend was reflected in Georgia, Tennessee, and Texas. Only in South Carolina did the urban-rural disparity in cancer death rates not increase between the two time periods studied.
● The 5-year cancer survival rate for all cancers was 8% lower in rural areas compared to urban areas. The research also showed that the urban-rural disparity in survival rates increases the later the stage the cancer is diagnosed. For example, cancers caught at the “local stage” (before it spread to other parts of the body) had a similar 5-year survival rate between urban (91.5%) and rural (89%) areas. But at the late (or distant) stage after the cancer has spread, 5-year survival was 30.2% in urban areas but only 26.2% in rural areas.
● Rural areas are behind urban areas when it comes to getting preventive screenings. This is especially true for colorectal cancer screenings, the rates of which were lower among rural areas nationwide and in the four states reviewed.
● Concerning colon and lung cancer specifically, the rates of both cancers found at late-stages were higher in rural areas than urban areas. Lung and colon cancers are the two most common cancers in the US that affect both men and women. According to the study, the rate of new lung cancer cases diagnosed at late-stages ranged from 21% to 25% higher in rural areas compared to urban areas between 2015-2019. Over that same period, the rate of new colon cancer cases diagnosed at late stages ranged from 12% to 18% higher in rural areas compared to urban areas.
VIEW THE FULL STUDY RESULTS HERE
Addressing the Rural-Urban Disparity in Cancer Outcomes
Cancer Resources from the GrangeThe Grange has a variety of resources available for people facing a cancer diagnosis including guides to help one understand a diagnosis, get one’s affairs in order, and how to become a patient advocate. You can access these resources HERE |
Nearly one in five Americans live in a rural area, so these challenges and impacts regarding cancer care have broad impacts on the nation’s overall health. People living in rural areas often struggle to access healthcare – due to poverty, a lack of insurance, or being located far from a provider – and as a result may not have the same access to screening services as people living in urban areas.
The best health outcomes related to cancer are linked to early detection. Routine screenings for breast, colorectal, cervical, prostate, and lung cancer have been successful in catching cancer early and savings lives. In addition, new technologies, notably multi-cancer early detection (MCED) testing offers new hope for further reducing rural cancer disparities in the future. These blood tests can detect dozens of types of cancers all at once – including those for which there is currently no other screening. And because MCED tests require only a blood draw, they can be more readily accessible and without the expensive equipment required for other types of screenings.
The FDA is in the process of reviewing these tests and is expected to grant approval over the next few years. But once they are approved, policy solutions will have to be in place to unlock their full potential. Today, the Medicare program does not currently have a straightforward pathway to covering MCED tests, which greatly impacts rural and other at-risk communities. Legislation to create such a pathway and ensure these tests can be accessed by those who need them the most has been supported by over 300 bipartisan Members of Congress last year.
These technologies have a critical role to play in addressing rural cancer disparities highlighted in this new study, but only if patients can access them.
