What people with cancer should know:

Guidance for cancer researchers:

Get the latest public health information from CDC:

Get the latest research information from NIH:

Mary E. Charlton

I am a Cancer Health Services Epidemiology Scientist/Researcher.

Mary E. Charlton, Ph.D.

University of Iowa

My ah-ha moment came when I realized that many cancer care providers in rural Iowa hospitals didn't know about the Iowa Cancer Registry or the data we collect from them; and since they weren't asking us for data, I wondered how they could know how they were doing in terms of quality of care. I wanted to help them understand the power of the data and create an infrastructure for quality improvement and monitoring.

Dr. Charlton is a cancer health services researcher and epidemiologist at the University of Iowa College of Public Health. She is also the Principal Investigator of the Iowa Cancer Registry, which is part of NCI's Surveillance, Epidemiology and End Results (SEER) program. Her research passions include cancer disparities, particularly related to rural-urban disparities in cancer treatment and outcomes. Her research has evolved from mainly secondary data analyses to primary data collection, including qualitative and survey research methods that she acquired through her recently completed NCI K07 Award. Her current R01 leverages all of these methods to assess the effectiveness and implementation of a health system intervention to improve quality of cancer care for rural, underserved patients.

Her analyses of Iowa Cancer Registry data indicated that approximately 40% of rural patients with breast or colorectal cancers received most or all definitive treatment in rural hospitals that do not collect or monitor data on their quality of cancer care and are far less likely to be accredited by the Commission on Cancer, a marker of high-quality care. In addition, the data suggested these patients were less likely to receive guideline-concordant care. Her interviews with cancer survivors in rural areas revealed they were so devasted and overwhelmed by their diagnosis that most didn't consider getting second opinions or researching providers online. Almost all went wherever the diagnosing provider recommended they go, which was often the same local hospital where they were diagnosed. This suggested that intervening directly with the community hospitals in these rural areas would be a promising strategy to improve quality of cancer care and outcomes. In the current project, Dr. Charlton and her multi-disciplinary team will adapt a collaborative network intervention to extend resources and expertise from an NCI-designated comprehensive cancer center to four rural hospitals and assist them in achieving the established Commission on Cancer standards of cancer care.

To request edits to this profile, please contact Mark Alexander at

Last Updated: 05/12/2021 12:48:30