Rural Patients With Cancer Face Higher Costs and Care Barriers, ACS CAN Finds

A new national survey released by the American Cancer Society Cancer Action Network (ACS CAN) reveals that more than half of patients with cancer and survivors living in rural communities face significant financial and logistical hurdles to obtaining necessary care.

The findings, presented at the ACS CAN 15th annual National Policy Forum on the Future of Health Care and detailed in a news release, underscore a growing crisis in oncology equity, where geographic location increasingly dictates patient outcomes.

According to the "Survivor Views" survey, which included 1,436 cancer patients and survivors diagnosed or treated within the last seven years, 53% of rural respondents reported difficulty affording their care. The financial strain has led to severe consequences: 50% of rural patients have incurred medical debt, and 44% reported that the cost of cancer treatment forced them to choose between healthcare and basic necessities, such as food.

The Toll of Geographic Isolation

For oncology nurses and navigators, the survey results quantify the daily struggles observed in clinical practice. Beyond the direct costs of treatment, rural patients face a unique set of "hidden" costs related to distance. More than one-third (37%) of rural respondents reported traveling over an hour to reach their primary oncology provider. Furthermore, 34% had to travel far enough that they or their caregivers required overnight lodging, the majority of which was paid for out-of-pocket.

These logistical barriers often lead to clinical non-adherence. Nearly a quarter (23%) of rural patients admitted to skipping or delaying recommended medical care, and another 23% reported skipping or delaying prescribed medications due to cost or access issues.

Delays in Screening and Prevention

The impact of rural residence extends to the earliest stages of the cancer continuum. The survey found that rural residents are less likely to be up to date on recommended cancer screenings compared to their urban and suburban counterparts. Specifically, 24% of rural respondents reported difficulty accessing screenings, compared to just 16% of suburban residents. Furthermore, 27% faced additional barriers when attempting to schedule follow-up care after a screening.

The Role of Patient Navigation

A critical takeaway for the oncology nursing community is the efficacy of patient navigation services in mitigating these disparities. The survey highlighted that rural patients with access to a patient navigator were less likely to view cost and access as insurmountable barriers and were more likely to report higher satisfaction with the quality of their care.

Patient navigators play a vital role in coordinating care, identifying financial assistance programs, and addressing social determinants of health like transportation and housing.

Policy Implications for Oncology Nursing

As the frontline of cancer care delivery, oncology nurses are uniquely positioned to advocate for the policy changes recommended by ACS CAN. These include:

• Sustainable funding for patient navigation services.
• Policies aimed at alleviating medical debt.
• Incentives to address healthcare workforce shortages in rural areas (23% of respondents reported delays due to staffing issues).

For oncology professionals, these survey results serve as a call to action to prioritize rural outreach and support systems that ensure all patients, regardless of their zip code, have a fair opportunity to survive cancer.

Reference

1. New ACS CAN survey finds more than half of cancer patients and survivors in rural communities report difficulty affording cancer care. American Cancer Society Cancer Action Network. May 13, 2026. Accessed May 13, 2026. https://www.fightcancer.org/releases/new-acs-can-survey-finds-more-half-cancer-patients-and-survivors-rural-communities-report