From the Journals

How to bridge the gap for rural cancer patients

Key clinical point: Enrollment in clinical trials eliminated disparities in survival between rural and urban cancer patients.

Major finding: Only rural patients with adjuvant-stage estrogen receptor–negative and progesterone receptor–negative breast cancer had worse overall survival (hazard ratio, 1.27) when patients had the same access to care.

Study details: A comparative effectiveness retrospective cohort analysis of 36,995 patients from all 50 states enrolled in 44 cancer trials from 1986 through 2012.

Disclosures: The National Cancer Institute and the HOPE Foundation supported the research. The researchers reported financial relationships with various pharmaceutical companies.

Source: Unger JM et al. JAMA Network Open. 2018;1(4):e181235. doi: 10.1001/jamanetworkopen.2018.1235.



New research suggests that better access to quality care may reduce disparities in survival between cancer patients living in rural areas of the United States and those living in urban areas.

The study showed that urban and rural cancer patients had similar survival outcomes when they were enrolled in clinical trials.

These results, published in JAMA Network Open, cast new light on decades of research showing that cancer patients living in rural areas don’t live as long as do urban cancer patients.

“These findings were a surprise, since we thought we might find the same disparities others had found,” study author Joseph Unger, PhD, of Fred Hutchinson Cancer Research Center, Seattle, said in a statement.

“But clinical trials are a key difference here. In trials, patients are uniformly assessed, treated, and followed under a strict, guideline-driven protocol. This suggests that giving people with cancer access to uniform treatment strategies could help resolve the disparities in outcomes that we see between rural and urban patients.”

Dr. Unger and his colleagues studied data on 36,995 patients who were enrolled in 44 phase 3 or phase 2/3 SWOG trials from 1986 through 2012. All 50 states were represented.

Patients had 17 different cancer types, including acute myeloid leukemia (AML), non-Hodgkin lymphoma (NHL), and multiple myeloma (MM).

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