This study examined a comprehensive database to quantify the distance and access to four types of cancer services in a sample of rural, Medicare-insured, colorectal cancer (CRC) patients of different racial and ethnic groups. CRC is the second most common cause of cancer death in the U.S., and disproportionately impacts racial and ethnic minorities. Cancer care requires a sophisticated set of surgical and medical resources more common in large urban settings. Greater proportions of rural cancer patients are diagnosed at later stages than urban patients and are less likely than urban patients to receive state-of-the-art cancer treatments. The database links Surveillance Epidemiology and End Results (SEER) cancer registry, Medicare claims, AMA Masterfile, and American Hospital Association data. This study will inform future work designed to understand discrepancies in cancer service use by the rural elderly in different racial and ethnic groups. A paper will be published in the Journal of Rural Health.

Publications

• Access to Cancer Services for Rural Colorectal Cancer Patients
  Journal Article
  WWAMI Rural Health Research Center
  Date: 2008
  Includes findings from a study to determine how far rural and urban colorectal cancer (CRC) patients travel to three types of specialty cancer care services-surgery, medical oncology consultation, and radiation oncology consultation.
• Access to Cancer Services for Rural Colorectal Cancer Patients (Project Summary)
  WWAMI Rural Health Research Center
  Date: 10/2007
  This summary provides a brief overview of findings from a study to determine how far rural and urban colorectal cancer patients travel to three types of specialty cancer care services: surgery, medical oncology consultation, and radiation oncology consultation.
• Explaining Black-White Differences in Receipt of Recommended Colon Cancer Treatment
  Journal Article
  WWAMI Rural Health Research Center
  Date: 2005
  

  Black-white disparities exist in receipt of recommended medical care, including colorectal cancer treatment. This retrospective cohort study examines the degree to which health systems (e.g., physician, hospital) factors explain black-white disparities in colon cancer care. Black and white Medicare-insured colon cancer patients have an equal opportunity to learn about adjuvant chemotherapy from a medical oncologist but do not receive chemotherapy equally. Little disparity was explained by health systems; more was explained by illness severity, social support, and environment. Further qualitative research is needed to understand the factors that influence the lower receipt of chemotherapy by black patients.