It is a common trope in business, healthcare and many other sectors—to be effective in our work, we cannot be confined to silos. While it may be a cliché, it is also true! Collaboration is key to success in any endeavor. This is particularly true in reducing rural health inequities. To be sure, rural America is not a monolith, nor is it exclusively an agricultural landscape– despite the ubiquitous images of fields of grain, red barns and silos. However, the image of a silo is particularly fitting. The main purpose of silos is to store silage, which is undried grass and other fodder used to feed animals during the winter. In other words, when we work in silos what we produce is unfit for human consumption. As we recognize National Rural Health Day on Thursday, November 17, 2022, we know that collaboration—not working in silos—will advance cancer and rural equity.

In 2005, the National Academies of Science, Engineering and Medicine released a report, Quality through Collaboration: The Future of Rural Health, emphasizing the importance of collaboration at all levels—among federal agencies, between community and healthcare partners, among health professional education programs, and across the continuum of care. This future of collaboration has become our present for all aspects of rural health and is notably true for efforts focused on reducing inequities in cancer prevention, treatment, outcomes and survivorship.

Collaboration is key for comprehensive cancer control programs and their development and updates of state comprehensive cancer control plans. Engagement of state cancer coalitions and connections with partners throughout the state is imperative to collective action to reduce the state’s cancer burden regardless of geography.  In a series of webinars developed by the Advancing Cancer and Rural Equity (ACRE) lab at the University of Iowa in collaboration with the Geographic Health Equity Alliance, we have emphasized the importance of including rural data and partners in comprehensive cancer control planning processes and the development of rural relevant goals, objectives, and strategies for these plans. One of these webinars included a panel of cancer coalitions and comprehensive cancer control program evaluators who shared how they engaged rural partners throughout their respective states through coalition workgroups, surveys, focus groups, and other efforts. Another webinar highlighted research and programmatic initiatives that aimed to improve colorectal and lung cancer screening through collaborations with healthcare providers, health systems, and non-profit organizations. Collaboration is key to developing, implementing, and evaluating cancer plans to address cancer inequities—among rural and other populations—in our states.

To conduct impactful research and initiatives to address rural cancer inequities, it is imperative for researchers to partner with healthcare providers and communities. For example, the CDC-funded Cancer Prevention and Control Research Network (CPCRN) is working in partnership with its network of eight collaborating centers, affiliates, and community partners. Collaborating centers are working with healthcare providers to increase HPV vaccination rates in rural communities, pharmacies to increase access to colorectal cancer screening such as fecal immunochemistry test (FIT) kits, and community advisory councils to provide mini-grants to increase cancer screenings that may have been missed due to the COVID-19 pandemic.

Collaboration will remain an instrumental part of advancing cancer health equity in rural communities. Comprehensive cancer control programs, state cancer coalitions, academic institutions and partners across sectors have shown the effectiveness of eschewing silos for meaningful and impactful partnerships that can provide a path forward for rural cancer control.