Measuring cancer equity globally: harmonising international rural-urban classifications for exploring cancer outcomes

Wright, C; Riva, S; Crichton, M; Rodi, H; Jongebloed, H; Leigh, L; Johnston, EA; Bergin, RJ; Chapman, A; Alston, L; Crawford–Williams, F; Hart, N; Rhee, J; Gao, L; Gunn, K; Gasper, H; Ugalde, A; Marshall, S

Measuring cancer equity globally: harmonising international rural-urban classifications for exploring cancer outcomes

Wright, C Riva, S Crichton, M Rodi, H Jongebloed, H Leigh, L Johnston, EA Bergin, RJ Chapman, A Alston, L Crawford–Williams, F Hart, N

Rhee, J Gao, L Gunn, K Gasper, H Ugalde, A Marshall, S

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Lancet Regional Health Western Pacific, 2026, 66, pp. 101737
Issue Date:: 2026-01-01

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Field	Value	Language
dc.contributor.author	Wright, C
dc.contributor.author	Riva, S
dc.contributor.author	Crichton, M
dc.contributor.author	Rodi, H
dc.contributor.author	Jongebloed, H
dc.contributor.author	Leigh, L
dc.contributor.author	Johnston, EA
dc.contributor.author	Bergin, RJ
dc.contributor.author	Chapman, A
dc.contributor.author	Alston, L
dc.contributor.author	Crawford–Williams, F
dc.contributor.author	Hart, N https://orcid.org/0000-0003-2794-0193
dc.contributor.author	Rhee, J
dc.contributor.author	Gao, L
dc.contributor.author	Gunn, K
dc.contributor.author	Gasper, H
dc.contributor.author	Ugalde, A
dc.contributor.author	Marshall, S
dc.date.accessioned	2026-02-19T23:24:58Z
dc.date.available	2026-02-19T23:24:58Z
dc.date.issued	2026-01-01
dc.identifier.citation	Lancet Regional Health Western Pacific, 2026, 66, pp. 101737
dc.identifier.issn	2666-6065
dc.identifier.issn	2666-6065
dc.identifier.uri	http://hdl.handle.net/10453/193664
dc.description.abstract	Geographic disparities in cancer outcomes represent a critical health equity challenge, with rural populations consistently experiencing poorer outcomes than urban populations. The lack of harmonised rurality measures creates substantial barriers to evidence synthesis and has precluded meta-analyses. This perspectives paper discusses concepts of rurality, identifies rurality classification systems used by cancer researchers in OECD countries that can be harmonised with the OECD Extended Typology, and develops recommendations for consistent rural-urban coding. Targeted searches of grey and published literature on cancer policy and rurality classification systems were conducted. The secondary analysis examined studies identified through systematic database searching of OVID Medline, Elsevier Embase, CINAHL, and Web of Science. From 289 studies across 22 OECD countries, twenty-seven rurality classification systems were identified, with eleven systems harmonised to create the Rural-Urban Classification System Harmonisation Framework featuring a consistent five-point rurality scale and standardised urban-rural dichotomisation. Implementation recommendations address system selection, standardised categorisation, and reporting standards. Adopting this harmonisation framework will improve research comparability and strengthen evidence to inform equitable cancer policies. Funding: Commonwealth of Australia's Medical Research Future Fund (MRF2030313).
dc.description.sponsorship	National Health and Medical Research Council (2017080)
dc.language	en
dc.publisher	Elsevier
dc.relation	http://purl.org/au-research/grants/nhmrc/2017080
dc.relation	Commonwealth Department of Health and Aged CareAPP2030313
dc.relation.ispartof	Lancet Regional Health Western Pacific
dc.relation.isbasedon	10.1016/j.lanwpc.2025.101737
dc.rights	info:eu-repo/semantics/openAccess
dc.subject.classification	3202 Clinical sciences
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4206 Public health
dc.title	Measuring cancer equity globally: harmonising international rural-urban classifications for exploring cancer outcomes
dc.type	Journal Article
utslib.citation.volume	66
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Faculty of Health/School of Sport, Exercise and Rehabilitation
pubs.organisational-group	University of Technology Sydney/UTS Groups
pubs.organisational-group	University of Technology Sydney/UTS Groups/INSIGHT: Institute for Innovative Solutions for Wellbeing and Health
pubs.organisational-group	University of Technology Sydney/UTS Groups/Human Performance Research Centre (HPRC)
pubs.organisational-group	University of Technology Sydney/UTS Groups/Stroke Research Collaborative
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.date.updated	2026-02-19T23:24:56Z
pubs.publication-status	Published
pubs.volume	66

Abstract:

Geographic disparities in cancer outcomes represent a critical health equity challenge, with rural populations consistently experiencing poorer outcomes than urban populations. The lack of harmonised rurality measures creates substantial barriers to evidence synthesis and has precluded meta-analyses. This perspectives paper discusses concepts of rurality, identifies rurality classification systems used by cancer researchers in OECD countries that can be harmonised with the OECD Extended Typology, and develops recommendations for consistent rural-urban coding. Targeted searches of grey and published literature on cancer policy and rurality classification systems were conducted. The secondary analysis examined studies identified through systematic database searching of OVID Medline, Elsevier Embase, CINAHL, and Web of Science. From 289 studies across 22 OECD countries, twenty-seven rurality classification systems were identified, with eleven systems harmonised to create the Rural-Urban Classification System Harmonisation Framework featuring a consistent five-point rurality scale and standardised urban-rural dichotomisation. Implementation recommendations address system selection, standardised categorisation, and reporting standards. Adopting this harmonisation framework will improve research comparability and strengthen evidence to inform equitable cancer policies. Funding: Commonwealth of Australia's Medical Research Future Fund (MRF2030313).

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http://hdl.handle.net/10453/193664