By Bill Thomas | September 12
One of our top priorities here at Pediatric Cancer Research Foundation is improving outcomes for childhood cancer patients by powering research that creates newer, safer, and more effective treatment options. What happens, though, when children who could benefit from these treatment options aren’t able to access them due to factors outside their control? If a family lives in a region where certain potentially life-saving therapies aren’t available to them, those therapies might as well not exist at all.
That’s why Pediatric Cancer Research Foundation is equally dedicated to ensuring equitable care for all childhood cancer patients, regardless of age, sex, race, ethnicity, economic status, or geographic location. The difficulty some children face in simply gaining access to therapies they need is a factor often overlooked and underestimated. One of the most powerful illustrations of the imbalance in cancer treatment availability can be seen when we look at the rural-urban divide.
In 2024, a University of Nebraska Medical Center study found that children diagnosed with cancers in rural counties had a 9% higher risk of death compared to children diagnosed in urban counties. A related study in 2025 found that pediatric cancer patients in rural counties not adjacent to urban counties had the highest risk of early mortality, with 27% of children succumbing within one year of diagnosis.
Why is this the case? Why are pediatric cancer patients in rural areas at a statistical disadvantage when compared to patients in more metropolitan areas? And, most importantly, what can we do to address this imbalance?
Why Do Families in Rural Areas Have Difficulty Accessing Pediatric Cancer Care Services?
Limited Resources & Ill-Equipped Facilities
The reduced availability of resources for those struggling with childhood cancers in rural areas is a microcosm of the reduced availability of resources for those struggling with childhood cancer in general. Because pediatric cancers tend to be rarer than adult cancers, there are fewer facilities properly equipped to care for pediatric cancer patients.
It’s important to remember that there are significant biochemical and physiological differences between adult and childhood cancers. Therapies for more aggressive and difficult-to-treat pediatric cancers often require specialized equipment and specially trained healthcare professionals that hospitals in more isolated rural communities are less likely to have on hand.
Long Distances & Exorbitant Expenses
A direct result of the limited availability of resources as outlined above is that rural families affected by childhood cancer often have to travel long distances to get the care they need. In some cases, families may have to travel across state lines or even cross-country multiple times a year to ensure their loved ones receive treatment.
In addition to increasing the mental and emotional stress that comes with a pediatric cancer diagnosis, requiring families to travel such long distances imposes major strain on their finances as well. When traveling far, parents and guardians of pediatric cancer patients have to pay for transportation, fuel, food, lodging, and other expenses. Not all families are able to absorb these kinds of costs.
Increased Poverty & Inadequate Insurance
As noted above, financing specialized treatment for pediatric cancer can be an expensive proposition for anyone, but rural families face an even steeper uphill battle. According to the U.S. Census Bureau’s Annual Social and Economic Supplement to the Current Population Survey, rural areas have consistently had higher rates of poverty since as far back as the 1960s.
Further exacerbating the issue is the fact that long-distance travel often requires parents and guardians of childhood cancer patients to take time off of work, which may result in lost income on top of travel expenses. A 2022-2023 report co-authored by the Urban Institute and the Robert Wood Johnson Foundation additionally found that rural areas have fewer insurance options, meaning that rural families are more likely to pay out-of-pocket for treatment.
What Can Be Done to Address the Rural-Urban Divide in Pediatric Cancer Care?
Expand Support & Improve Access
Earlier this year, Pediatric Cancer Research Foundation proudly announced its goal of raising $25 million over the next five years. A key priority in that initiative is to help fund efforts to address healthcare inequities. One way we seek to do that is by supporting measures that make it easier for families in rural areas to get the treatment they need.
Travel assistance programs, for example, can help ease the financial burden of families who don’t have access to certain specialized medical facilities or specially trained healthcare professionals locally. We’re also actively working to increase support for clinical trials that target diverse populations and underrepresented communities.
Leverage Technology & Foster Collaboration
Even with financial assistance, some distances are too vast for any family to travel. Fortunately, technology may be able to help us bridge those distances in ways previous generations could never have imagined. Although further study is required to properly gauge their effectiveness, telehealth services have shown promise in enabling patients in underserved communities the chance to connect with medical experts from all over the world.
Furthermore, by building partnerships between urban and rural healthcare systems, larger and better equipped hospitals and treatment facilities are able to share their data, resources, and expertise with smaller centers whose own capabilities are more limited. This would effectively provide families affected by pediatric cancers with “the best of both worlds,” allowing them to access previously out-of-reach resources without having to uproot themselves.
Grow Resources & Improve Options
As beneficial as all the above-described measures are, arguably the best way to address geographically rooted healthcare inequities is the most straightforward: to expand and improve those resources which patients in rural communities have access to. A big way to do that is through research. Research drives the kind of innovation that is necessary to make highly specialized therapies more viable, to make specialized equipment more efficient, affordable, and widely available, to make specialized techniques less complex and more adaptable.
Research, of course, requires researchers. Oncology departments require oncologists. Hospitals require a steady inflow of new doctors and nurses, new patient advocates and medical educators. Growing the healthcare workforce is integral not just to ensuring that rural communities are supported, but that the childhood cancer community as a whole is supported. Our Survivor Scholarship program is just one example of how Pediatric Cancer Research Foundation works to facilitate the next generation of caregivers.
The rural-urban divide in pediatric cancer is a real problem, one that won’t be solved overnight. Progress is being made, however, and studies show the gap is shrinking. With your help, we believe that a world where everyone has equal access to life-saving treatment regardless of their age, sex, race, ethnicity, economic background, or geographic location.
If you would like to help us continue supporting projects that provide healthcare to all children please consider becoming a donor. To stay up-to-date with all the latest news shaping the future of pediatric cancer treatment, don’t forget to follow Pediatric Cancer Research Foundation’s Profectus Blog!