Recent evidence suggests that there are differences in cancer outcomes between metropolitan and rural/regional services in Australia and internationally. Reasons for these differences are not entirely clear, but as a consequence rural and regional cancer services are on the political agenda in Australia. The report by the Clinical Oncological Society of Australia, Mapping Regional and Rural Oncology Services in Australia, March 2006, explored issues of access and quality of care and made a number of recommendations for improvement. Governments across Australia have initiated cancer service improvement programs, but not always specifically targeting regional disparities. The way forward may be hampered by an existing lack of rural/regional health services research, however some potential solutions are explored.