Quality of Life and Impact of Cancer: Differences in Rural and Nonrural Non-Hodgkin's Lymphoma Survivors.

Journal Article (Journal Article)


People living in rural areas experience greater health disparities than their nonrural counterparts, but little is known about the association between rural status and quality of life (QOL) in non-Hodgkin's lymphoma (NHL) survivors. We compared self-reported quality of life and impact of cancer in rural and nonrural NHL survivors.


This study is a secondary analysis of 566 NHL cancer survivors recruited from cancer registries at 2 large academic medical centers in 1 state. Standardized measures collected information on demographics and clinical characteristics, quality of life (QOL; SF-36), and the Impact of Cancer (IOCv2). Rural residence was determined by Rural-Urban Commuting Area (RUCA) codes designated as nonmetropolitan. Multiple linear regression analysis, adjusted for demographic and clinical covariates, was used to evaluate the relationship between rural residence and QOL and impact of cancer.


Among the 566 participants (83% response rate), rural residence was independently associated with lower SF-36 physical component summary scores and the physical function subscale (all P < .05). Rural residence was also associated with higher IOCv2 positive impact scores and the subscales of altruism/empathy and meaning of cancer scores in the adjusted models (all P < .05).


Given documented rural cancer disparities and the lack of resources in rural communities, study findings support the continued need to provide supportive care to rural cancer survivors to improve their QOL. Consistent with previous research, rural residence status is associated with increased positive impact following cancer diagnosis.

Full Text

Duke Authors

Cited Authors

  • Noonan, D; LeBlanc, M; Conley, C; Benecha, H; Leak-Bryant, A; Peter, K; Zimmerman, S; Mayer, D; Smith, S

Published Date

  • September 2020

Published In

Volume / Issue

  • 36 / 4

Start / End Page

  • 536 - 542

PubMed ID

  • 32472708

Pubmed Central ID

  • PMC7529644

Electronic International Standard Serial Number (EISSN)

  • 1748-0361

International Standard Serial Number (ISSN)

  • 0890-765X

Digital Object Identifier (DOI)

  • 10.1111/jrh.12420


  • eng