Americans living in rural areas have been identified by several federal agencies as a priority population affected by health disparities. Disparities have been identified in cancer screening, diagnosis and treatment for rural residents. However, although an estimated 21% or more of all United States cancer survivors reside in rural areas, little is known about their long-term cancer survivorship experience. This population may be at risk for poorer survivorship care and health outcomes due to a variety of reasons, including long travel distances to obtain care, a limited number of primary and specialty healthcare facilities, lower socioeconomic status, and limited cancer-related knowledge. This proposal seeks to: 1) establish the feasibility of using a hospital cancer registry to locate and recruit post-treatment cancer survivors residing in rural areas and 2) gather preliminary data on the cancer-related follow-up care experiences, perceived barriers to care, and information needs of two to five year cancer survivors residing in rural areas. This information will be obtained through a cross- sectional mail and telephone survey of approximately 180 breast, prostate and colorectal rural survivors, recruited from the cancer registry of an academic medical center serving a large rural population. The proposed research will expand our currently limited understanding of cancer-related follow-up care experiences, perceived barriers, and information needs among cancer survivors in rural areas. Increased knowledge about rural cancer survivors addresses an NCI Strategic Objective, to overcome cancer health disparities, and will guide future proposals to develop interventions addressing health disparities in rural cancer survivors. The data we collect in this exploratory R03 study about response rates and variability in outcomes are the necessary foundation for a larger observational study comparing urban and rural survivors. The information we will gather on follow-up care experiences, survivorship needs, and barriers to receipt of follow-up care will inform the development of soundly designed future interventions to improve the cancer-related follow-up care experiences of post-treatment survivors. These may include interventions designed to improve patient-physician communication and coordination among physicians via the development of survivorship care plans, or interventions focused on improving knowledge and understanding of follow-up care among rural survivors. Finally, this study will launch the career of a new investigator in cancer health disparities and build a foundation for her future work in rural cancer survivorship.

Public Health Relevance

Despite documented rural health disparities in cancer screening, diagnosis and treatment, little is known about the post-treatment follow-up care experiences of rural cancer survivors. The goal of the proposed research is to survey rural breast, prostate, and colorectal cancer survivors recruited from an academic medical center cancer registry to gather preliminary data on the cancer-related follow-up care experiences, barriers, and information needs of two- to five-year cancer survivors residing in rural areas.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Small Research Grants (R03)
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Special Emphasis Panel (ZCA1-SRLB-B (M2))
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Mitchell, Sandra A
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Wake Forest University Health Sciences
Public Health & Prev Medicine
Schools of Medicine
United States
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