Rural cancer research activity across Europe: A bibliometric analysis on patterns, gaps and policy implications

Rural populations comprise around 27% of Europeans and face persistent challenges across the cancer pathway. Although rurality is recognised as a contributor to cancer inequalities, most evidence has historically been generated outside Europe. No comprehensive mapping of European rural cancer research exists and understanding where evidence is concentrated or absent is important for informing equitable cancer-policy planning. We mapped rural cancer research activity across Europe, including publication trends, geographical distribution, collaboration patterns, and thematic focus.

We conducted a bibliometric review in accordance with the BIBLIO Guidelines for Reporting Bibliometric Reviews of the Biomedical Literature. Data were retrieved from Scopus and Web of Science (1940-2025), processed in R (4.5.1), and analysed using the bibliometrix package. Analyses included annual output, citation metrics, country and institutional productivity, collaboration networks, thematic mapping, and Multiple Correspondence Analysis.

A total of 2050 publications were analysed. Annual output increased at a growth rate of 6.04%. Research activity was unevenly distributed, with the UK, France, Germany, Poland, and Italy as the most productive countries. Collaboration networks were strong, especially among Western European nations. Thematic analysis showed a focus on screening, epidemiology, and specific tumour types, with limited research on treatment, survivorship, and service delivery-patterns relevant for European cancer policy.

Rural cancer research in Europe is uneven and thematically narrow. Integrating rurality into cancer-inequality monitoring, incorporating rural indicators into EU policy frameworks, and strengthening research capacity in under-represented countries are timely, achievable steps to support more equitable cancer policy and planning.