June marks National Cancer Survivors Month, a time to reaffirm our awareness of and commitment to meeting the needs of cancer survivors and their caregivers. While some individuals with a history of cancer do not identify with the term “cancer survivor”, a cancer survivor is often defined as anyone with a history of cancer beginning at the time of diagnosis through the remainder of their life. As of January 1, 2022, there were estimated to be more than 18 million cancer survivors in the United States and that number is expected to grow to 26 million by 2040.
The National Comprehensive Cancer Control Program (NCCCP) was established to address the needs of communities with the highest cancer burden. A vital part of equitable cancer care is ensuring the needs of cancer survivors and their caregivers are met. The NCCCP prioritizes this in the following ways:
- Surveillance to assess survivors’ needs.
- Education programs to help survivors, caregivers, and providers make informed decisions.
- Patient navigation systems to optimize treatment and care.
- Policies and systems change to improve access to palliative care and other cancer resources or services.
Transportation barriers and lack of access to specialized care negatively impact survival rate and psychological health in rural communities. However, rural primary care can play an important role in supporting the needs of cancer survivors. A study from the Rural and Minority Health Research Center found that most practitioners at Medicare-certified Rural Health Clinics were involved in some aspect of survivorship care with over 90% of practitioners involved in care related to smoking cessation, diet and physical activity counseling, treating sexual dysfunction, and/or treating depression and anxiety among survivors.
Additionally, the CDC is piloting a program, “Improving Health and Wellness of Cancer Survivors in Rural Communities”, by leveraging Project ECHO, a telementoring program that engages patient navigators to improve care for cancer survivors, in four pilot states: Kansas, Montana, Nevada, and South Carolina. This pilot project provided training for 16 patient navigators who were able to provide support for 164 cancer survivors. This project also facilitated connections with federally qualified health centers and state primary care associations, aligned goals for sustainability, used patient navigation software to track contacts, developed and implemented a marketing plan, and adapted existing evidence-based programs.
State coalitions also have the opportunity to address the needs of their cancer patients and survivors through patient navigation. For example, the Iowa Cancer Consortium recently launched the Iowa Oncology Navigation Network which sprung out of a project from the Consortium’s Rural Cancer Workgroup that aimed to connect Iowa’s professionals who provide resources and support to cancer patients, survivors, and caregivers. As the number of cancer survivors grows, it will continue to be imperative that survivors and caregivers receive the care and support that they need no matter where they live.
See video below for stories from the Iowa Cancer Plan.
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.