Public Health Strategies to Help Cancer Survivors in Rural Communities
A Practice Guide for Health Practitioners
People living in rural areas of the United States face higher cancer mortality than people living in urban areas, despite lower overall cancer incidence.1 Rural cancer survivors typically have limited access to cancer care specialists and rely on primary care providers for ongoing survivor care.
Telementoring through Project ECHOexternal icon (Extension for Community Healthcare Outcomes) and patient navigation are two promising approaches to improve cancer survivor care in rural areas.2–5 Project ECHO uses telementoring within communities of practice to increase workforce capacity and enhance rural health care providers’ knowledge and skills. At the same time, patient navigation aims to remove barriers to care across the cancer care continuum and connect survivors with the community resources they need.
CDC’s Pilot Program
The Centers for Disease Control and Prevention’s (CDC’s) Division of Cancer Prevention and Control selected four National Comprehensive Cancer Control Program (NCCCP) award recipients (pilot sites) to conduct a pilot project, Improving the Health and Wellness of Cancer Survivors in Rural Communities.
The pilot project’s goal was to bridge the health equity gap experienced by cancer survivors in rural communities. For 12 months, each pilot site implemented telementoring and patient navigation strategies aligned with the needs and resources of its rural population. The pilot project provided valuable insight into the successful implementation of these strategies to improve care for cancer survivors. This practice guide highlights four keys to success that health practitioners can use to support cancer survivors in rural areas.
- Kansas Department of Health and Environment
- Montana Department of Public Health and Human Services
- Nevada Cancer Coalition
- South Carolina Department of Health and Environmental Control
1Henley SJ, Anderson RN, Thomas CC, Massetti GM, Peaker B, Richardson LC. Invasive cancer incidence, 2004–2013, and deaths, 2006–2015, in nonmetropolitan and metropolitan counties—United States. MMWR Surveillance Summaries 2017;66(14):1–13.
2Freeman HP, Rodriguez RL. History and principles of patient navigation.external icon Cancer 2011;117(15 Suppl.):3539–3542.
3Alverson DC. An introduction to project ECHO.external icon Rural Health Quarterly 2017.
4Bhavaraju N, Nanni JE, Carlson C, Sholk J, Peterson K, Smith LA. Breaking the barriers to specialty care: Practical ideas to improve health equity and reduce cost.external icon 2016.
5O’Neil ME, Henley SJ, Rohan EA, Ellington TD, Gallaway MS. Lung cancer incidence in nonmetropolitan and metropolitan counties—United States, 2007–2016. MMWR 2019;68:993–998.