Medical and psychosocial care needs of cancer patients: a systematic review comparing urban and rural provisions

Background and objective: The psychological and oncological care needs of patients with cancer and an adequate structure for their medical care have so far been only marginally considered with regard to disparities in patients' residence (rural or urban). Even though there are thought to be such differences, for example with regard to existing care services and obvious specific care needs for patients in rural areas. This study addresses these issues in a systematic survey of the pertinent literature. Methods: Publications in the last ten years dealing with identified problems were reviewed. A total of 27 studies met the criteria for analysis. Results: Significant differences between medical care, psychosocial stress and the desired support were reported. Rural patients were more likely to be at a disadvantage compared with their urban counterparts with regard to medical care, being more often burdened cumulatively, and they strongly expressed the wish for psychological and oncological care. But the comparability of these results and transferring these findings to conditions in Germany proved difficult. Conclusion: When investigating the demand for psycho-oncological care, one needs to be aware of potential differences between rural and urban areas. Hence, in order to reliably distinguish between rural and urban living areas, a set of concrete criteria which define rural and urban surroundings needs to be established.