Rural residency and its associations with symptom experience and overall health in pediatric cancer patients

Children with cancer are at increased risk for poor overall health and elevated symptoms, however, the potential influence of rural residence on these outcomes remains understudied. This exploratory study examined associations between rurality and self-reported symptoms and overall health among pediatric oncology patients. Children receiving active cancer treatment or within six months of treatment completion were recruited from two children’s hospitals in the Midwestern United States. Residential addresses were used to classify participants as rural or non-rural and to calculate travel distance to the oncology clinic. Symptoms were assessed using the Memorial Symptom Assessment Scale, and overall health was measured using the PROMIS Pediatric Global Health Scale. Descriptive statistics, correlations, chi-square tests, one-samples and independent samples t-tests were conducted. Seventy-six children aged 8–17 years (M = 13.4, SD = 3.2) participated, with 67% residing in non-rural and 33% in rural areas. Participants were predominantly White (88%), male (65%), and diagnosed with hematologic malignancies (53%). In this pilot study, rural participants reported lower perceived overall health, t(74) = 4.32, p < .001 compared with non-rural. These preliminary findings suggest that rural residence may be associated with poorer perceived overall health among children with cancer. Larger studies are needed to better understand potential geographic disparities in pediatric oncology outcomes.