Background Cancer is a long-term condition with biopsychosocial components. People with cancer living in rural areas can have poorer treatment outcomes and higher rates of unmet psychosocial needs than those in urban areas. Cancer, as opposed to other chronic conditions, poses a unique challenge in this current COVID-19 pandemic context, given immunocompromised states of patients and long-term survivor treatment effects. The disaggregated impact of psychosocial issues potentiated by the pandemic on rural vs. urban cancer populations is yet to be quantified. This rapid review investigates whether (i) people with cancer are experiencing pandemic-related psychosocial impacts, (ii) these impacts are equivalent in urban and rural locations, and (iii) whether the rapid uptake of telehealth mitigates or reinforces any identified impacts. Method A rapid review was conducted for literature published between December 2019 and 13 August 2021. Results Fifteen papers were included, incorporating evidence from five countries. The available literature suggests people affected by cancer living in rural areas are evidencing disproportionate psychosocial impacts of COVID-19, compounding cancer experiences. Despite its widespread and necessary use during the pandemic, telehealth was identified as an additional challenge for rural people with cancer. Conclusions Clinicians working with rural people affected by cancer should ensure recognition of the greater risks of psychosocial concerns in their rural patients, and reduced access to health services. Whilst telehealth and other remote technologies are useful and necessary in this pandemic era, clinicians should consider whether its use benefits their rural clients or reinforces existing disparities.

Purpose: An increasing body of evidence indicates that people with cancer experience psychosocial concerns across the entirety of their cancer experience from pre-diagnosis to survivorship. These concerns have not just a deleterious effect on their medical journey, but impact more broadly across well-being and, importantly, the well-being of the people that love and care for them. Whilst most oncology research focuses on patients, the role and experiences of families and carers is increasingly recognised as a core component of health service delivery. Methods: This paper outlines an evaluation of the psychosocial experiences of 125 rural people accessing cancer services through three health services in rural NSW. Results: Despite an increasing and improved focus on rural heath equity, and the funding of high-quality rural cancer services over the past decade, the findings of this study suggest that cancer patient and carer populations in rural NSW experience concerning levels of psychological distress and barriers to accessing quality healthcare. Conclusions: The combination of high psychological need for patients and carers with insufficiency and inaccessibility of psychosocial support services have substantial implications for service provision and the psychological wellbeing of those they service. Under-detection of psychosocial need and a lack of support services poses a significant challenge for rural people with cancer and for those that care for them; this must be an urgent priority for quality improvement and equitable health care provision.