# Disparities in Lung Cancer Health Outcomes and Access to Lung Cancer Screening Between Rural and Urban Areas in the U.S

## TL;DR

This paper reviews how rural areas in the U.S. face worse lung cancer outcomes and less access to screening compared to urban areas, and suggests ways to improve care.

## Contribution

The paper provides a comprehensive synthesis of rural-urban disparities in lung cancer outcomes and screening access, along with targeted recommendations for improvement.

## Key findings

- Rural areas have higher lung cancer incidence and mortality rates compared to urban areas.
- Access to lung cancer screening and healthcare services is significantly lower in rural regions.
- Socioeconomic, environmental, and psychosocial factors contribute to disparities in rural lung cancer outcomes.

## Abstract

This narrative review aims to highlight disparities in health outcomes between rural and urban areas in the United States as well as psychosocial, environmental, medical, and policy-level factors influencing these disparities, while emphasizing differences in access to lung cancer screening between rural and urban areas. It provides further recommendations and interventions that can be implemented to increase access to lung cancer screening and care from the lens of the patient, caregiver, and healthcare provider.

Lung cancer is one of the leading causes of mortality in the United States. Despite overall declines in incidence and mortality nationwide, rural communities continue to experience higher rates of lung cancer incidence and mortality than their urban counterparts, a disparity that has persisted over recent decades. This review synthesizes evidence from epidemiologic and clinical studies evaluating rural–urban differences in lung cancer incidence, mortality, diagnostic stage, access to screening, and treatment outcomes. Factors influencing these differences—tobacco use and environmental exposures, socioeconomic inequities, access to healthcare, and psychosocial and spiritual support—are examined as well. The review highlights the importance of increasing access to lung cancer screening and suggests interventions to improve early detection, access to treatment, and enhance psychosocial and spiritual support for patients and caregivers residing in rural areas. In this review, we have followed the urban–rural classification designated by the United States Census Bureau as a rural area consisting of populations, housing, and territory not included within an urban-classified area.