News, Culture & Society

Rural Americans are more afraid of cancer than city-dwellers

Rural Americans are more afraid of cancer than city-dwellers, a new report finds.

Researchers at the Mayo Clinic found that those who live in rural areas are more likely to believe statements such as ‘everything causes cancer’ and that survival odds are slim.

They were also less likely to want to know what their risk was of developing any type of cancer. 

The team says this ‘fatalistic’ attitude could paradoxically prevent people in rural areas from quitting cigarettes and getting screened for cancers because there is a feeling that it would all be in vain.

But that isn’t going to change without better access to information and care, they say. 

More accessible, regular check-ups with doctors – something lacking in the rural US – could help residents spot signs of disease earlier, curbing the rate of seemingly sudden, deadly cancers, the report declares.

Given the lack of accessible centers and the distrust of the medical industry, they say churches could even be used as a pulpit to educate people about the disease.

A new survey from the Mayo Clinic found that those who live in rural areas are more likely to believe statements such as ‘It seems like everything causes cancer’ (file image)

For the report, the team sent out surveys between July and December 2017 from areas where Mayo Clinic Cancer Centers are located – including Arizona, Florida and Minnesota – and received nearly 1,200 replies. 

Participants in rural areas were more likely to agree with fatalistic statements such as ‘It seems like everything causes cancer’ and ‘There is not much you can do to lower your chances of getting cancer’.   

Figures from the Centers for Disease Control and Prevention show that deaths from cancer is higher in rural America. 

And a 2018 study from Southern Illinois University School of Medicine found that cancer incidence rates were declining in urban populations almost twice as much as in rural populations.

This is largely because warning signs are not spotted and relevant experts to speak to are not available.

‘In rural areas, you have fewer resources in general,’ Dr Thomas Ricketts, an adjunct professor of health policy and management at the University of North Carolina Gillings School of Global Public Health, told  

‘If you only have a local doctor you go to, you might not have a variety of people to ask to check on things.’

In fact, one of the only things that people in rural areas know about health is that a cancer diagnosis could disrupt their lives. 

‘They may need to travel a [far] distance to receive the care they need,’ Lisa Davis, director of the Pennsylvania Office of Rural Health at Penn State University told    

‘They might be worried about traffic and parking and getting lost and time away from work, and that can contribute to anxiety about the disease in general.’ 

Rural residents were also more likely to agree with ‘There are so many different recommendations about preventing cancer, it’s hard to know which ones to follow’.

In response to the question ‘How worried are you about getting cancer?’, rural populations were most likely to reply ‘extremely’. 

Additionally, regardless of sociodemographic factors such as race or household income, those in rural areas were more likely to say they didn’t want to know what their risk is of developing cancer. 

Lead author Kristin Harden, a health services researcher at the Mayo Clinic, says these beliefs could have deadly consequences. 

‘If you have these fatalistic beliefs that everything causes cancer, you might think: “So what’s the point in me getting my yearly mammogram or getting my colonoscopy?”‘ she told

‘And if you don’t know what your cancer risk is, you don’t know the preventative services you should be participating in.’  

Researchers don’t know why people in rural areas are more pessimistic or fearful when it comes to cancer, but one reason may be quality of care. 

‘People in rural areas are more uninsured during parts of the year, which means the place where they can get their care is the local hospital,’ Davis said.

‘What that means is they’re missing out on a large component of a comprehensive healthcare program because what’s treated in the ER is undersign symptoms not the underlying cause.’

The team says it hopes to directly speak with rural dwellers about why they have these fears and come up with customized interventions. 

One way is by going to churches, which is often where rural residents from strong social networks, to educate.

Another is by bringing some of the services that are far away directly to the rural populations.  

‘Being able to have scans and low-dose CT screenings can sometimes overcome some of those barriers,’ said Davis.

‘That doesn’t mean literally bringing the CT scan out, but if someone from the urban hospital comes and they’re not wearing their lab coat but jeans and an open-collar shirt and leaning up against the table talking, it might ease some of that fear and anxiety.’