A rapid systematic review on the experiences of cancer survivors who resided in rural areas during the Covid-19 pandemic.

Background: The Covid-19 pandemic has caused considerable disruption to cancer care and may have exacerbated existing challenges that cancer survivors from rural areas already face. This has created an urgent need for a rapid evidence synthesis of current impacts so that interventions, support and resources can be tailored to the needs of rural cancer survivors as they continue to deal with the consequences of the pandemic. Aims: This rapid systematic review aimed to identify peer-reviewed evidence relating to cancer survivors who resided in rural areas during the Covid-19 pandemic. Methods: The review was conducted in line with the recently published guidance from the Cochrane Rapid Review Methods Group and was reported using the PRISMA checklist. Keyword searches were performed in EBSCOHost (inc. MEDLINE, CINAHL and PsycINFO), Scopus and Web of Science from 20/10/21 – 15/11/21. Peer reviewed articles that were published after March 2020 that reported primary data (quantitative and qualitative) in relation to the experiences of adult cancer survivors who resided in rural and remote settings during the pandemic were included. Findings were reported thematically. Outcomes: Twelve studies were included in the review. Five themes emerged from the data (1) general coping ability (2) access to and support for healthcare (3) increased anxiety and depression (4) loneliness (5) differences between older and younger rural cancer survivors. Across the studies rurality had a mostly detrimental impact on cancer survivors experiences during the pandemic when compared to urban areas and pre-covid-19. However, rural cancer survivors were less likely to experience loneliness due to a strong sense of community. Increased access to green and outdoor spaces meant that they were able to continue with some of their routine social activities and exercise habits