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<p>Cancer care delivery research (CCDR) is increasingly acknowledging the critical role of geographic context; however, most definitions of rurality remain insufficiently granular. Grouping all non-urban areas into a single category mask the distinct barriers faced by individuals in remote and frontier regions. Patients living in these areas often navigate long travel distances, rugged terrain, seasonal inaccessibility, and limited healthcare infrastructure—factors that collectively affect diagnosis, treatment access, survivorship, and psychosocial outcomes. Despite growing interest in rural cancer disparities, few studies incorporate nuanced measures of rurality that account for these realities. This commentary outlines a research agenda that prioritizes extreme rurality in CCDR, highlighting promising metrics (RUCA, FAR, ARRS, ARIA+) and advocating for multilevel models that contextualize rurality alongside social determinants. Addressing these priorities will advance targeted interventions and promote equity in cancer care delivery.</p>

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The cancer divide: setting research priorities for understanding and addressing extreme rurality in cancer care delivery

  • 期刊论文

  • 发表日期：

    2025年9月26日

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  • Rebecca L. Hoover,
  • Deborah K. Mayer,
  • Echo L. Warner,
  • Emily R. Haines

摘要

Cancer care delivery research (CCDR) is increasingly acknowledging the critical role of geographic context; however, most definitions of rurality remain insufficiently granular. Grouping all non-urban areas into a single category mask the distinct barriers faced by individuals in remote and frontier regions. Patients living in these areas often navigate long travel distances, rugged terrain, seasonal inaccessibility, and limited healthcare infrastructure—factors that collectively affect diagnosis, treatment access, survivorship, and psychosocial outcomes. Despite growing interest in rural cancer disparities, few studies incorporate nuanced measures of rurality that account for these realities. This commentary outlines a research agenda that prioritizes extreme rurality in CCDR, highlighting promising metrics (RUCA, FAR, ARRS, ARIA+) and advocating for multilevel models that contextualize rurality alongside social determinants. Addressing these priorities will advance targeted interventions and promote equity in cancer care delivery.