Bringing Cancer Care to Rural Communities

For cancer survivors, life after treatment is often described as a “new normal.” There are follow-up appointments, scans and lingering side effects. For those living in rural America, that new normal is often intensified by another challenge: access to qualified care. 

Distance, time and resources shape healthcare in rural communities. Specialist appointments may be a two-hour or more drive. Finding transportation, childcare or time off work is difficult, and many clinics don’t have the staff or resources to manage the needs of cancer survivors. 

Researchers at The University of Kansas Cancer Center are working to change that, bringing high-quality survivorship care closer to home.

Over a Decade of Data 

For more than 10 years, members of the KanSurvive team have studied the unique barriers facing rural cancer survivors. As the second phase of the project, KanSurvive 2.0 is expanding from research to real-world solutions in primary care clinics throughout rural Kansas and western Missouri. 

The initiative is led by Jennifer Klemp, PhD, MPH, co-leader of the cancer center’s Cancer Prevention and Control research program, and K. Allen Greiner, MD, MPH, professor of family medicine and community health. Together, they are testing ways to help rural physicians provide survivorship care close to home. 

The Rural Challenge 

Rural communities account for 62% of US counties and about 16% of the nation’s population. In Kansas, 26% of people live in rural counties, where healthcare faces unique hurdles. Higher rates of tobacco use and obesity as well as lower screening rates contribute to an increased risk of cancer. Once diagnosed, a patient is normally met with additional challenges to receive specialized treatment or follow-up care. 

“Rural cancer survivors often face hurdles that go beyond medical treatment. Long travel distances and limited specialist availability can put their long-term health at risk,” says Dr. Greiner. “By equipping primary care providers with the right tools and knowledge, we can help survivors get the follow-up care they need without leaving their communities.” 

Survivorship care is different for everyone. A breast cancer survivor may need ongoing hormone therapy and bone density checks. Someone treated for colorectal cancer may need regular colonoscopies. Follow-up needs mustaddressed by primary care providers, according to Bryan Dennett, MD, a family medicine practitioner in Winfield, Kansas. 

“One of the challenges we face as a clinic is that patients are often not aware that they need special follow-up after surviving cancer, so it falls on us to initiate that care,” Dr. Dennett says. “In our rural community, we want to coordinate as much of that survivorship care process as we can in-house since access to care is limited and traveling to a larger city is a barrier to many patients.” 

Tailored Care 

KanSurvive 2.0, which is recruiting practices for its second wave, uses the Project ECHO model. Instead of asking people to travel for care, the model brings expert knowledge to rural providers through virtual learning networks. 

Rural clinics receive guidance on following the latest cancer survivorship best practices, support to strengthen electronic health record systems for better coordination and tools to track outcomes and evaluate cost-effectiveness. One immediate impact has been simply improving documentation; many patients’ prior cancer histories were not fully preserved. 

“A lot of our patients were not even recorded as having previously had cancer,” notes one participating nurse. “Just getting the ‘problem list’ updated has been a huge thing.” 

That small step makes a big difference in ensuring follow-up care is accurate, timely and tailored to each person. 

No Patient Left Behind 

The goal of KanSurvive is not just to improve survivorship care in Kansas and western Missouri, but to create a model that can be scaled across the country. By embedding best practices in rural primary care, the team ensures that cancer survivors have access to the support they need to thrive. 

“For survivors, these efforts could mean fewer long trips to cancer centers and more confidence in their local provider,” says Dr. Klemp. “For rural physicians, it’s a chance to strengthen care delivery and ensure patients are not left behind.”