April marks National Cancer Control Month, a time to re-affirm our awareness of and commitment to cancer control activities. Cancer control encompasses cancer prevention, early detection, treatment, and providing support for patients, survivors, and caregivers to improve cancer outcomes, survival, and overall quality of life. Comprehensive cancer control programs play a critical role in improving cancer outcomes across this continuum by supporting policy, system, and environmental approaches, evaluating these approaches and interventions, and promoting health equity.
In cancer prevention and control, health equity ensures that every person, regardless of who they are or where they live, can live a healthy life, including those who are part of populations who are disproportionately affected by cancer. One such population are those who live in rural communities. Roughly one in five Americans, more than 59 million persons, live in a rural area. In some states, as much as 69% of their population is rural.
Rural populations in the United States face several risk factors for cancer-related health disparities compared to their urban counterparts which may contribute to their higher rates of cancer incidence and mortality, lower rates of utilization of some cancer screening services and lower adoption of cancer-relevant health behaviors. Rural populations are less likely to have health insurance and have less access to primary care practitioners and cancer care specialists which in turn may make it more difficult to access important preventive, screening and treatment services that may play a role in rural cancer disparities across the continuum. Studies indicate that rural populations may have less awareness regarding the link between HPV and cancer which may affect whether they seek and receive HPV vaccination. Further, rural populations have a higher rate of tobacco use and are less likely to engage in cancer-relevant primary prevention activities like HPV vaccination, regular physical activity and healthy eating habits.
Rural cancer prevention and control is of increasing importance in recent years. In fall 2019, the National Advisory Committee on Rural Health and Social Services developed a set of recommendations on rural cancer prevention and control. One recommendation focuses on the inclusion of a rural-relevant description of the cancer mortality burden and the development of rural-specific goals, objectives and strategies in comprehensive cancer control planning processes among states, tribal organizations and territories. An assessment of comprehensive cancer control plans made available on the CDC’s website in January 2020 revealed that roughly two-thirds of comprehensive cancer control plans included rural in some capacity. However only about one third of plans included rural-specific “action-oriented” components such as goals, objectives and strategies.
Comprehensive cancer control programs have a unique opportunity to provide a blueprint for addressing rural disparities within their states. Further, rural communities’ close-knit nature and other assets provide an opportunity for collaboration and synergy to address these disparities. To help programs include rural in their planning processes going forward, the Geographic Health Equity Alliance (GHEA) will facilitate a 4-part webinar series in the coming months focused on the topics below.
Webinar Topics:
- Defining and describing rural communities and integrating rural-specific data in comprehensive cancer control planning – Webinar one will focus on how “rural” is commonly defined and what data sources are available to describe the rural cancer burden and cancer risk factors to incorporate into comprehensive cancer control plans. Completed on June 6, 2022. View the webinar recording.
- Building partnerships to support rural cancer control – Webinar two will discuss how to build partnerships with rural partners and highlight state plans and consortia who have ensured rural voices are at the table. Completed on August 16, 2022. View the webinar recording.
- Setting rural-focused goals, objectives and strategies – Webinar three will provide best practices for developing goals, objectives, and strategies that address both the unique challenges and strengths of rural communities.
- Identifying and implementing evidence-based strategies for rural cancer control -Webinar four will highlight examples of evidence-based strategies for cancer control and how these have been effectively implemented in rural communities, organizations and clinical settings.
Pleased stay tuned for more information on the dates and times of these webinars!
Whitney Zahnd
Whitney Zahnd, PhD is an assistant professor at the University of Iowa's Department of Health Management and Policy and full member of the Holden Comprehensive Cancer Center. Her research employs health services research, social epidemiological, and spatial methods to address rural cancer disparities across the cancer continuum and to evaluate access to health care services. She has a particular interest in reducing cancer disparities among rural minority populations. Dr. Zahnd serves on the board of the Iowa Rural Health Association.