Study examines US rural cancer control plans to address disparities

Published on September 13, 2021

A new study from researchers at the University of Iowa College of Public Health and the Arnold School of Public Health at the University of South Carolina (UofSC) found that only about one-third of U.S. states, territories, and tribal organizations have made plans to address rural cancer mortality disparities through their required comprehensive cancer control plans.

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In 2019, National Advisory Committee on Rural Health and Social Services released a set of recommendations on rural cancer control which included a recommendation to address these disparities and provide rural-specific strategies as part of their comprehensive cancer control planning. However, there was not any baseline data on whether these plans already included this data. This new study sought to provide a baseline assessment of rural inclusion in these plans.

The analysis and paper were led by Sydney Evans, an MPH student at the University of Iowa, and Cathryn Murphy, an undergraduate student at the University of South Carolina. Dr. Jan Eberth at UofSC and Dr. Natoshia Askelson and Dr. Whitney Zahnd at UI were also involved in the study. Zahnd, assistant professor of health management and policy at the UI who was at UofSC at the time of the study said, “Cathryn’s and Sydney’s leadership in reviewing these dozens of plans was instrumental to the study.”

The team reviewed the Comprehensive Cancer Control Plans for all U.S. states, territories, and tribal organizations to see if they included rural-specific data, like cancer rates, or developed rural-specific goals, objectives, or strategies. The research team found that about two-thirds of these groups considered “rural” in their plans and only about one-third of plans included a rural-specific strategy.

“As rural populations have higher cancer mortality rates, higher incidence rates for some of the more preventable cancers, and lower cancer screening rates, it is important that they are appropriately considered,” Zahnd says. “Our study helps provide information on how these plans include rural as one way of using research to facilitate public health changes.”

Zahnd says that one way that the inclusion of rural can be improved is by ensuring that rural stakeholders are participating in the planning process. “The Cancer Prevention and Control Research Network’s Rural Cancer Workgroup is currently interviewing a sample of program directors to see how they have included rural stakeholders in their planning processes,” she says. “We hope that these interviews will give us a better understanding of how rural health care providers, public health departments, cancer survivors, advocates, and others are involved in the planning process. If these stakeholders aren’t at the table, then that may be why some are not addressing rural in any way or aren’t developing strategies to improve rural cancer rates.”