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Study Finds Rural Iowans Less Likely To Receive Guideline-Recommended Cancer Care

Cancer patients who are treated at hospitals accredited the Commission on Cancer are linked to better outcomes.

A recent study by the University of Iowa found many rural Iowans may not be receiving care that meets an accrediting group’s standards.
The study found that 40 percent of rural Iowans diagnosed with breast, lung and colorectal cancers were being treated in hospitals not accredited by the Commission on Cancer.

The commission, which is part of the American College of Surgeons, recognizes programs that provide high-quality care to cancer patients.

Mary Charlton, an associate professor with the University of Iowa Department of Public Health, said hospitals that are accredited by the commission are linked to better outcomes for cancer patients.

"For an example, for colon cancer patients, they're supposed to have at least 12 lymph nodes examined during their surgery for colon cancer, and that's been a pretty established measure that's linked to survival," said Charlton. "And when we looked at rural patients, 73 percent of them who went to a non- accredited hospital met that measure, compared to 88 percent of those going to a CSC-accredited hospital."

Charlton said because of this, rural cancer patients who are at a non-accredited hospital could consider consulting another provider.

"A lot of people will just like to stay locally where it's familiar, and they may know the hospital better or the providers better," she said. "But really, sometimes it's best to really consider some options, maybe get a second opinion."

Charlton said she's working to develop a system to connect the University of Iowa with smaller hospitals to better coordinate cancer care. Most of the state's critical-access hospitals treat fewer than 100 cancer patients a year, she said.

"Hospitals in Iowa just really need to work together a little bit better. Make sure there's good coordination of care, good communication, and make sure that no matter where a patient lives, they can have access to high-quality care," she said.

Natalie Krebs is IPR's Health Reporter and collaborator with Side Effects Public Media. Krebs has expertise covering health news and issues, including maternal health and rural health care access. She's covered abortion access and women's health care in Iowa and the Midwest, news from Iowa's state health agencies, and medical care and health concerns for elders. Krebs is a graduate of the University of Texas at Austin.