Introduction: Access to oncology care in Poland remains uneven, with rural residents limited to specialist availability. We analyzed geographic factors that may worsen cancer outcomes and deepen health disparities in Poland between rural and urban inhabitants.

Objectives: This study aims to evaluate the impact of geographic and demographic factors on cancer diagnosis in central Poland, focusing on disparities between urban and rural populations.

Methods: A retrospective cohort analysis was conducted on 4,771 patients suspected of having cancer at the Nikolay Pirogov Specialized District Hospital in Łódź between 2020 and 2024. Clinical records and public health datasets were analyzed. Logistic regression was used to assess associations between cancer diagnosis and variables such as distance to the nearest hospital, residence type (urban vs. rural), age, and sex. Models were adjusted for potential confounders.

Results: Of the 4,771 patients evaluated, 2,996 (62.8%) received a cancer diagnosis and 1,775 (37.2%) did not. In multivariable models, living 5–10 km from the hospital (vs. <5 km) was associated with higher odds of confirmed diagnosis, while residence types were not independently associated with diagnosis. We explicitly limited inference to individuals who ultimately accessed hospital care.

Conclusion: Geographic accessibility showed a localized association within the 5–10 km band, whereas residence >10 km and urban/rural status did not demonstrate independent effects after adjustment. These findings are hypothesis-generating and should be interpreted as indicators of potential access pathways among hospital-admitted patients, rather than causal effects. Targeted interventions (e.g., mobile diagnostics, transportation support, and optimized referral pathways) warrant evaluation.