Solving the Rural Access Cancer Challenge

By Alti Rahman

Chief Strategy and Innovation Officer

July 31, 2026 in Education, Patient-centric Care

Cancer outcomes are shaped by more than biology. They are also influenced by where patients live, whether they have reliable transportation, how quickly they can reach a specialist, and whether they can afford the non-medical costs associated with treatment. For people in rural communities, these factors are often exacerbated, creating significant barriers to timely, consistent care.

According to the 2020 U.S. Census, about 20% of the population (66 million people) live in rural areas. In these settings, healthcare infrastructure is often limited, and specialty services may be hours away.

As with all healthcare, those distances matter. Rural residents experience higher cancer mortality rates, lower screening rates, and are more likely to be diagnosed at later stages than people living in urban areas. Addressing these disparities is essential to achieving a more equitable cancer care system.

Rural Access Is a Structural Challenge

In healthcare, “rural” generally refers to areas outside metropolitan centers with lower population density and fewer medical resources. While geography is part of the challenge, the underlying issue is structural. Many rural communities face shortages of oncologists, radiation therapists, oncology nurses and pharmacists. Some hospitals have reduced services or closed altogether, leaving patients with fewer local options.

Infrastructure limitations extend beyond the clinic. Public transportation is often scarce. Broadband access may be inconsistent, limiting telehealth opportunities. Pharmacies may be located far from patients’ homes, complicating access to oral cancer medications and supportive therapies.

Rural communities often overlap with areas of high socioeconomic disadvantage, but deprivation exists in both rural and urban settings, making the Area Deprivation Index (ADI) a useful tool for identifying communities where patients may face greater barriers to cancer care.

Patient Experience in Rural Communities

For many rural patients, cancer treatment requires repeated travel for chemotherapy, radiation therapy, and follow-up appointments. A single infusion visit may involve several hours of driving, time away from work, childcare arrangements, and out-of-pocket expenses for gas, meals, and lodging.

These indirect costs can be substantial — even when treatment is covered by insurance. Patients may delay appointments because they cannot afford to miss work or cover transportation or housing expenses.

Care coordination also becomes more complicated when services are fragmented across multiple sites. Imaging may be performed locally, treatment delivered elsewhere, and supportive services provided through separate organizations. Navigating this system can be overwhelming for patients and caregivers already coping with a cancer diagnosis.

How Distance Affects Outcomes

Distance has a measurable impact on outcomes. Patients who travel longer distances are more likely to miss appointments, delay treatment, and struggle to maintain medication adherence. Symptoms may go unaddressed until they require emergency intervention.

These disruptions can lead to avoidable hospitalizations, lower treatment completion rates, and poorer clinical outcomes. Emotional and physical burdens also increase, as patients and caregivers devote additional time, energy, and financial resources simply to access care.

This is why access must be defined more broadly than geographic proximity. Effective access includes continuity of care, affordability, reliable coordination, and practical support that enables patients to stay on treatment.

Why Community Oncology Matters

Community oncology offers a practical solution by delivering high-quality cancer care in local settings rather than concentrating services in large academic medical centers. This model allows patients to receive treatment closer to home, reducing travel time and minimizing disruptions to daily life.

Community-based practices also tend to foster stronger relationships between patients and care teams. Because treatment is delivered locally, clinicians often have a deeper understanding of the challenges their patients face and can respond more quickly when issues arise.

In addition to improving convenience, community oncology can reduce overall care costs while maintaining access to advanced therapies, diagnostics, and supportive services.

Building Sustainable Rural Access

Long-term progress depends on preserving independent oncology practices that serve rural and underserved communities. These practices need the infrastructure to remain financially and operationally sustainable, including access to care management programs, technology, specialty pharmacy services, and value-based care support.

Organizations such as American Oncology Network help independent practices access these resources while allowing physicians to continue caring for patients in their own communities. AON supports more than 350 providers across 21 states, many of whom practice in areas where local oncology services are critical to patient access.

Sustaining these practices is essential because once a local cancer center closes, patients may face significantly longer travel times and greater disruption throughout treatment.

Addressing Non-Medical Barriers

Improving rural cancer care also requires addressing barriers outside the clinic. Transportation assistance, lodging support, nutrition resources, and financial counseling can make the difference between completing treatment and falling behind.

Many community oncology practices offer dedicated care navigation to help patients coordinate appointments, manage medications, and connect with community resources. Telehealth can also reduce unnecessary travel for symptom management and follow-up visits when appropriate.

Programs such as American Oncology Cares provide eligible patients with financial assistance for expenses such as transportation, utilities, and food. These types of services reinforce a central principle: Access includes not only proximity, but also affordability and support.

A Shared Responsibility

Closing the rural cancer care gap will require coordinated action across the healthcare system. Policymakers should support payment models that reflect the realities of rural practice. Providers should continue investing in care navigation, partnerships, and technology. Community organizations and nonprofits can help address transportation and financial barriers that interfere with treatment.

Cancer doesn’t respect geographic boundaries, and, regardless of geography, every patient deserves the opportunity to receive timely, high-quality treatment close to home. Solving the rural access challenge is a critical step toward ensuring that distance does not determine destiny.