Getty Images

News

Cost, trust drive rural health's cancer screening disparities

Rural Americans are less likely to have completed their requisite cancer screenings, mostly due to rising costs and waning trust in health systems and providers.

Sara Heath
By
Published: 08 Jul 2026

Less than half of adults living in rural America are up to date on their cancer screenings, revealing significant care gaps and geographic health disparities that warrant attention, according to the Prevent Cancer Foundation.

As part of the advocacy group's annual reporting on cancer screening gaps, the organization found that rising cost pressures, trust and convenient care access get in the way.

Care gaps aren't unique to rural areas, but according to the foundation's 2026 Early Detection Survey, they are pronounced in those regions. Nationwide, 73% of adults are behind on at least one cancer screening, the data showed.

But when segmenting by geography, a clear delineation is emerging. Just over half (56%) of those living in urban or suburban areas said they've had a routine medical appointment or cancer screening this year. That number sinks to 48% when looking at folks living in rural areas.

Still, regardless of geography, the biggest barrier to cancer screening remains cost, the data showed.

Across all geographies, 34% of adults said cost gets in the way of their routine cancer screenings. Among those living in rural regions, that figure is 39%.

Low trust limits cancer screening for rural patients

It's not just cost keeping rural Americans from routine cancer screening. According to the survey, those living in rural areas are less likely to trust the healthcare system, which in turn makes them less likely to engage with it.

Specifically, 55% of rural Americans believe the healthcare industry puts profits over patients.

And while the data shows urban and suburban patients tend to trust their individual healthcare provider, that's not necessarily true for those living in rural regions. For example, 25% of rural patients reported feeling dismissed or unheard by their clinicians, compared with 20% of urban and suburban respondents.

Still, rural Americans are open-minded about their healthcare, with 48% telling the researchers that clear and consistent communication from their clinicians would help them build trust in the healthcare system, particularly when it comes to cancer screening.

Healthcare professionals working in rural areas might consider new patient-provider communication skills and approaches to patient education to fill in the gaps.

For example, rural Americans are less likely to have their children vaccinated against HPV, which is a key cancer prevention measure. This is an opportunity to engage rural patients in preventive care services.

Rural healthcare providers might also focus on other lifestyle changes, such as a healthy diet and smoking cessation, as rural patients are less likely to believe they can reduce the risk of cancer by adopting such changes.

Supporting convenient access to care

Like their urban and suburban counterparts, rural Americans would prioritize more convenient, less invasive ways to receive cancer screenings.

For example, 48% of rural respondents said they'd be more likely to get a cervical cancer screening if they could self-administer the test in a clinic or doctor's office. Meanwhile, a third said they'd be more likely to prioritize colorectal cancer screening if they could avoid a colonoscopy. Specifically, 32% would be interested in at-home tests, and 30% would consider blood tests.

"It's clear from the data that barriers in rural communities go beyond access—they show a need to improve trust, information sharing and the patient experience," Jody Hoyos, CEO of the Prevent Cancer Foundation, said in a press release.

"When people feel heard, receive clear information and can access routine screenings in ways that work for their lives, they are more likely to take action," she added. "That's where we have an opportunity to make meaningful, lasting change."

Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.

Dig Deeper on Patient advocacy