ASPO Abstracts
An Assessment of Cancer Capacity and Resources in Rural Arizona
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
The purpose of this study was to describe capacity and services for breast, cervical, colorectal, and lung cancer in
Arizona’s low populous areas.
Clinical organizations were surveyed to assess on-site cancer services (screening, diagnosis, and treatment) and
numbers of healthcare providers were pulled from the Center for Medicare and Medicaid Services, which were
converted to county-level per capita rates. Rural Urban Continuum (RUC) codes were used to designate county
metropolitan status. County demographic information from the US Census Bureau, income data from the US
Bureau of Economic Analysis, and unemployment rates from the US Department of Labor were included.
Descriptive statistics (means and standard deviations) were used to summarize the results. A student’s t-test was
used to evaluate differences between rural and urban counties.
Out of Arizona’s 15 counties, 13 were represented. Six were urban (RUC codes 1 – 3) and seven were rural (RUC
codes 4 – 7). Urban counties had a larger average population (216,773) than rural counties (49,507) (p-value =
0.01). Rural counties had more per capita clinical sites (20.4) than urban counties (8.9) (p-value = 0.02). Rural
counties had more per capita cervical cancer screening sites (18.9) than urban counties (7) (p-value = 0.02) and
rural counties had more per capita colorectal cancer screening sites (15.7) than urban counties (2.5) (p-value =
0.02). Urban counties had more per capita gastroenterologists (2.2) than rural counties (0) (p-value = 0.02) and
urban counties had more per capita pathologists (1.0) than rural counties (0) (p-value = <0.01). Rural counties had
zero medical oncologists. Per capita, rural counties with RUC codes 4 and 6 had hematology and oncology
physicians (0.3, 2.5) and radiologists (2.8, 6.0) but those with RUC code 7 had zero. Although not significantly
different, rural counties with RUC code 6 had three times as many per capita registered nurses (306.7) than urban
counties (90.8).
While rural counties may have more physical infrastructure, they lack specialists integral to providing cancer
services. Although this may contribute to urban rural cancer disparities, non-physician clinical providers may be
more prevalent in rural areas and represent opportunities for improving
Keywords: rural, cancer, disparities