Improving Access to High-Quality Cancer Care in Rural Communities

Where a person lives should not determine the quality of cancer care they receive.

For millions of Americans living in rural communities, getting appropriate cancer screening, treatment, and follow-up care may require traveling long distances, navigating shortages of specialists, or receiving services from hospitals with limited resources.

The American College of Surgeons is working to help close these gaps through a new rural accreditation category from the ACS Commission on Cancer (CoC). The category gives eligible rural hospitals a practical, evidence-based framework for strengthening their cancer programs and providing more comprehensive, coordinated care closer to where patients live.

Bringing Quality Cancer Care Closer to Home

The ACS Commission on Cancer has developed a new accreditation category specifically for eligible hospitals serving rural communities. The new rural category helps hospitals in rural areas meet accreditation criteria while maintaining a strong focus on standards that have been shown to improve the quality of cancer care. The category was developed with direct input from rural hospitals and health professionals who understand the realities of delivering cancer care in rural communities.

How Accreditation Can Help Patients

Accreditation is not simply a recognition or designation. It establishes systems that can help hospitals evaluate and continually improve the care they provide.

Through Commission on Cancer accreditation, participating rural hospitals can:

• Strengthen coordination among surgeons, oncologists, primary care clinicians, nurses, and other members of the cancer care team.
• Establish processes for connecting patients with screening, treatment, rehabilitation, psychosocial support, and survivorship services.
• Measure whether patients are receiving care that follows evidence-based guidelines.
• Identify gaps in local services and develop strategies to address them.
• Review patient outcomes and compare performance over time.
• Help more patients receive appropriate care within their own community.
• Clearly communicate to patients and families that the hospital has made a commitment to comprehensive, high-quality cancer care.

When specialized treatment is not available locally, an accredited hospital can also help patients navigate referrals and coordinate care with larger regional cancer centers.

Using Data to Improve Cancer Care

Hospitals accredited by the Commission on Cancer submit information to the National Cancer Database, one of the nation’s largest clinical cancer registries. The database captures nearly 75% of newly diagnosed cancer cases in the United States and includes detailed information such as cancer stage and the first course of treatment a patient receives.

Participating hospitals receive performance reports that allow them to:

• Evaluate the care provided in their own hospital.
• Track outcomes and quality measures.
• Identify areas where patients may not be receiving recommended care.
• Compare performance with other cancer programs.
• Develop targeted quality-improvement initiatives.

This turns hospital data into practical information that cancer teams can use to improve care for their patients.

A Framework Designed for Rural Hospitals

Hospitals located in counties classified as Rural-Urban Continuum Codes, or RUCC, 4–9 are eligible to pursue the rural accreditation category. RUCC is a U.S. Department of Agriculture classification system that describes how urban or rural a county is based on factors such as population size and its relationship to nearby metropolitan areas.

Accreditation in Action

Rural hospitals that build stronger cancer programs can help patients receive more of their care locally.

At Outer Banks Health, a 19-bed hospital in Nags Head, North Carolina, accreditation from the Commission on Cancer and the National Accreditation Program for Breast Centers was associated with significant improvements in local cancer care.

After accreditation:

• The percentage of breast cancers detected through screening increased from 44% to 63%.
• Survival improved among men with advanced prostate cancer.
• The percentage of patients receiving cancer care locally increased from approximately 10%–20% to more than 70%.

Research has also found that socially vulnerable patients with colon or rectal cancer were more likely to receive guideline-recommended care and had a lower risk of death when treated at a Commission on Cancer-accredited hospital than at a hospital without accreditation.

What Patients Can Do

Patients and families can ask their health care team:

• Is this hospital or cancer program accredited by the ACS Commission on Cancer?
• Which cancer services can I receive locally?
• Will I need to travel for any part of my treatment?
• Who will coordinate my care if I see clinicians at multiple hospitals?
• Are transportation, lodging, financial counseling, or telehealth resources available?
• What support is available after treatment, including rehabilitation and survivorship care?
• How does the cancer program measure and improve the quality of its care?

Rural Cancer Care Resources

Find a CoC-Accredited Program
Search for hospitals and cancer programs that participate in ACS Quality Programs. More hospitals in rural areas will be added as they become accredited under this new category.

Learn about CoC Accreditation
Explore how accreditation supports comprehensive, multidisciplinary, patient-centered cancer care.

Explore CoC Rural Cancer Program Accreditation
Learn about the new accreditation category developed for eligible hospitals serving rural communities.