The American College of Surgeons' (ACS) Commission on Cancer (CoC) has introduced a Rural Cancer Program Accreditation, providing a new accreditation pathway tailored to hospitals in rural counties, thereby expanding access to high-quality cancer care for individuals living in rural communities.
The ACS CoC is a consortium of professional organizations working to improve patient survival and quality of life. The CoC accreditation demonstrates that a hospital or cancer center meets more than 30 quality standards across the full cancer care continuum.
“Research shows that CoC accreditation improves access to high-quality care and enhances outcomes, reducing complications and death,” said Ronald J. Weigel, MD, FACS, PhD, Medical Director of the ACS Cancer Programs. “Previously, some rural hospitals could not pursue accreditation due to resource constraints. The new category makes accreditation, and the benefits that accompany it, more attainable by tailoring the standards to the needs and resources of rural hospitals.”
Existing accreditation requirements, including some staffing and patient service criteria, were modified for the Rural Cancer Program Accreditation so that they could meet the needs and resources of hospitals in rural areas, where cancer death rates are currently about 15% higher than in urban areas due to reduced access to screening, specialist care, and coordinated cancer care.
As about 60% of rural counties do not have an active general surgeon and 66% of rural counties do not have an oncologist, patients in these areas are less likely to receive guideline-concordant treatment and care.
“CoC accreditation is unique in addressing the full continuum of cancer care and providing a roadmap for delivering coordinated, high-quality health care from screening through diagnosis and survivorship,” said Ingrid Lizarraga, MBBS, FACS, CoC State Chair of Iowa and a breast surgical oncologist with the University of Iowa Hospitals & Clinics. “This new category will expand access to accreditation and provide rural hospitals with a practical, evidence-based framework to strengthen their cancer programs.”
The ACS has demonstrated that accreditation can improve outcomes, expand services, and strengthen local care. A 2025 study showed that patients with colon and rectal cancer who had high social vulnerability were 95% more likely to receive guideline-recommended care if they were treated at a CoC-accredited hospital vs one that was not accredited. Further, these patients had a 9% lower risk of cancer mortality.
Accredited hospitals are required to submit data the National Cancer Database, and they receive performance reports in return, allowing them to track and evaluate their performance over time and identify further gaps in care to mend within their own hospital.
“Using CoC standards strengthens hospitals’ ability to provide comprehensive cancer care and continuously improve quality,” said Dr. Lizarraga. “Accreditation also signals to the community that high-quality cancer care is available close to home."
If a hospital is in a RUCC 4-9 designated county, they are eligible to apply for the new accreditation category. With the USDA classification system, the RUCC system determines how urban or rural a county is based on population size, proximity to nearby metropolitan areas, etc.
After a hospital has achieved 1 year of compliance with the accreditation program's standards, they can request a site visit to secure accreditation.
Additional information is available from the American College of Surgeons' Commission on Cancer.
