“Don’t settle”: Rural cervical cancer survivors’ navigation of cancer care from an intersectional framework
Trisha L. Raque, Olivia Pointer, Maggie Creegan, Sarah Moody, Meredith Boyd, Noelle Grieco, Orphea WrightBackground
Approximately 13,000 women in the United States are diagnosed with cervical cancer and approximately 4000 women die from it annually. Although there has been an overall decline in mortality rates for cervical cancer, the mortality rates for women in rural areas are 42% higher than for urban areas. Given rural cervical cancer disparities, it is important to identify how to improve this population’s cancer care.
Objectives
By applying intersectionality theory, we explored the unique healthcare experiences of rural women diagnosed with cervical cancer. The goal of this study was to examine (1) how rural cervical cancer survivors describe their cancer care needs and barriers and (2) rural cervical cancer survivors’ perspectives on optimal cancer care.
Design
Utilizing an exploratory qualitative study design, we conducted approximately 60-minute semi-structured individual interviews with ten cisgender women diagnosed with cervical cancer residing in five different rural areas of the United States.
Methods
Data were analyzed utilizing reflective thematic analysis.
Results
Data revealed six themes: (1) “No treatment options around here”; (2) “Don’t dismiss us”; (3) “Certain things aren’t talked about”; (4) “Being more trauma-informed”; (5) “You really need to stick up for yourself”; and (6) “They cared about my well-being outside of just being a patient.” Taken as a whole, these themes demonstrate the ways that rurality, gender, and cancer type intersected to impact the type and quality of care received by rural cervical cancer survivors.
Conclusions
As with many cancer survivors, rural cervical cancer survivors value care that respects their bodily autonomy and treats survivors holistically. Trauma-informed survivor-provider interactions are critical for improving outcomes for rural cervical cancer survivors whose location may limit their choices in providers and how they access care. Providers can address intersectional barriers to enhance shared decision-making, survivor self-advocacy, and affirming cancer care.