We recently highlighted that cancer mortality rates are most pronounced in rural counties, probably not least because folks with generally fewer resources are faced with unique access to care challenges. This cancer registry study paired with detailed medical records and claims data using the same US Rural-Urban Continuum Codes to determine, across a geographically and racially diverse population, that rural populations have both worse radiation adherence as well as worse overall survival. When looking at a considerable number of variables, the number of missed radiation fractions was the strongest predictor of death, again most pronounced within rural areas. Experiencing a treatment delay was also more common in rural areas and strongly associated with subsequent missed fractions and worse survival. In fact, survival at 2 years was 27% for rural patients with a treatment delay versus 76% for nonrural residents without one. | Morris, Int J Radiat Oncol Biol Phys 2023
