Rural–Urban Differences in Colorectal Cancer Screening Capacity in Arizona
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
Colorectal cancer can be prevented via screening by the detection and removal of colorectal adenomas. Few data exist on screening capacity by rural/urban areas. Therefore, the aims of this work were to evaluate current colorectal cancer endoscopy screening capacity and to estimate potential volume for rural and urban regions in Arizona. Gastroenterologists and colorectal surgeons practicing in Arizona completed a survey (n = 105) that assessed current colonoscopy and sigmoidoscopy screening and estimated future capacity. Resources needed to increase capacity were identified, and differences between rural and urban regions were examined. Responders were more likely to practice in an urban region (89.5%). Physicians reported performing 8,717 endoscopic procedures weekly (8,312 in urban and 405 in rural regions) and the vast majority were colonoscopies (91% in urban and 97% in rural regions). Urban physicians estimated being able to increase their capacity by 35.7% (95% confidence interval 34.7–35.7) whereas rural physicians estimated an increase of 53.1% (95% confidence interval 48.1–58.0). The most commonly cited resource needed to increase capacity was a greater number of physicians in urban regions (52.1%); while the top response in rural areas was appropriate compensation (54.6%). Lastly, 27.3% of rural physicians noted they did not need additional resources to increase their capacity. In conclusion, Arizona has the ability to expand colorectal cancer screening endoscopic capacity; this potential increase was more pronounced in rural as compared to urban regions.
- American Cancer Society. (2008). Cancer facts & figures 2008. Retrieved April 17, 2008, from http://www.cancer.org/downloads/STT/CAFF2008finalsecured.pdf
- U.S. Department of Agriculture, Economic Research Service. (2004). ERS/USDA briefing room-measuring rurality: Rural–urban continuum codes. Retrieved November 10, 2008, from http://www.ers.usda.gov/briefing/rurality/ruralurbcon/
- Arizona Department of Health Services. (2007). Cancer in Arizona. Cancer incidence and mortality 2002–2004. Retrieved November 10, 2008, from http://www.azdhs.gov/phs/phstats/acr/pdf/AzAnnualRpt_0204_Final.pdf
- Walsh, J. M., & Terdiman, J. P. (2003). Colorectal cancer screening: Scientific review. JAMA, 289(10), 1288–1296. CrossRef
- Levin, B., Lieberman, D. A., McFarland, B., Smith, R. A., Brooks, D., Andrews, K. S., et al. (2008). Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: A joint guideline from the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA: A Cancer Journal for Clinicians, 58(3), 130–160. CrossRef
- National Cancer Institute. (2000). NCI conquering colorectal cancer: A blueprint for the future—The report of the Colorectal Cancer Progress Review Group (Vol. 2004). Bethesda, MD.
- Shenson, D., Bolen, J., Adams, M., Seeff, L., & Blackman, D. (2005). Are older adults up-to-date with cancer screening and vaccinations? Preventing Chronic Disease, 2(3), A04.
- Beydoun, H. A., & Beydoun, M. A. (2008). Predictors of colorectal cancer screening behaviors among average-risk older adults in the United States. Cancer Causes and Control, 19(4), 339–359. CrossRef
- Berkowitz, Z., Hawkins, N. A., Peipins, L. A., White, M. C., & Nadel, M. R. (2008). Beliefs, risk perceptions, and gaps in knowledge as barriers to colorectal cancer screening in older adults. Journal of the American Geriatrics Society, 56(2), 307–314. CrossRef
- Hiatt, R., Wardle, J., Vernon, S., Austoker, J., Bistanti, L., Fox, S., et al. (2005). Workgroup IV: Public Education. UICC International Workshop on Facilitating Screening for Colorectal Cancer, Oslo, Norway (29 and 30 June 2002). Annals of Oncology, 16(1), 38–41. CrossRef
- Centers for Disease Control and Prevention (CDC). (1997 and 2006). Behavioral risk factor surveillance system survey data. Retrieved November 12, 2008, from http://apps.nccd.cdc.gov/brfss/
- Larson, S. L., & Hill, S. C. (2003). Rural–urban differences in usual sources of care and ambulatory service use: Analyses of national data using Urban Influence Codes. Medical Care, 41(7 suppl), III65–III74.
- Kinney, A. Y., Harrell, J., Slattery, M., Martin, C., & Sandler, R. S. (2006). Rural–urban differences in colon cancer risk in blacks and whites: The North Carolina Colon Cancer Study. The Journal of Rural Health, 22(2), 124–130. CrossRef
- Hawley, S. T., Chang, S., Risser, D., & Zhang, Q. (2002). Colorectal cancer incidence and mortality in Texas 1990–1992: A comparison of rural classifications. The Journal of Rural Health, 18(4), 536–546. CrossRef
- United States Department of Agriculture (USDA). (2007). County-level population data for Arizona. Retrieved November 12, 2008, from http://www.ers.usda.gov/Data/Population/PopList.asp?ST=AZ&LongName=Arizona
- U.S. Census Bureau. (2005). Total population for regions, divisions, and states: 2000 to 2030. Retrieved May 2, 2008, from http://www.census.gov/population/www/projections/projectionsagesex.html
- U.S. Census Bureau. (1997). Current population reports. Population projections: States, 1995–2025. Retrieved April 12, 2008, from http://www.census.gov/prod/2/pop/p25/p25-1131.pdf
- American Cancer Society. (2007). 2007 strategic plan progress report. Retrieved June 25, 2008, from http://www.cancer.org/downloads/AA/2007_Strategic_Plan_Progress_Report.pdf
- Hoffman, R. M., Stone, S. N., Herman, C., Jung, A. M., Cotner, J., Espey, D., et al. (2005). New Mexico’s capacity for increasing the prevalence of colorectal cancer screening with screening colonoscopies. Preventing Chronic Disease, 2(4), A19.
- SAS Institute, Inc. (2007). SAS/STAT®, Version 9.1.3 [computer software].Cary, NC.
- Cokkinides, V., Bandi, P., Siegel, R., Ward, E. M., & Thun, M. J. (2007). Cancer prevention & early detection facts & figures 2008. Atlanta, GA: American Cancer Society.
- Coughlin, S. S., & Thompson, T. D. (2004). Colorectal cancer screening practices among men and women in rural and nonrural areas in the United States, 1999. The Journal of Rural Health, 20(2), 118–124. CrossRef
- Centers for Disease Control and Prevention (CDC). (2004). Behavioral risk factor surveillance system survey data. Retrieved November 12, 2008, from http://apps.nccd.cdc.gov/brfss/
- Iowa Department of Public Health. (2006). Iowa’s capacity for colorectal cancer screening: 2003 survey summary report. Retrieved April 27, 2008, from http://www.idph.state.ia.us/hpcdp/common/pdf/colorectal_report_2003.pdf
- Brown, M. L., Klabunde, C. N., & Mysliwiec, P. (2003). Current capacity for endoscopic colorectal cancer screening in the United States: Data from the National Cancer Institute Survey of Colorectal Cancer Screening Practices. American Journal of Medicine, 115(2), 129–133. CrossRef
- Butterly, L., Olenec, C., Goodrich, M., Carney, P., & Dietrich, A. (2007). Colonoscopy demand and capacity in New Hampshire. American Journal of Preventive Medicine, 32(1), 25–31. CrossRef
- Sonnenberg, A., Amorosil, S. L., Lacey, M. J., & Lieberman, D. A. (2008). Patterns of endoscopy in the United States: Analysis of data from the Centers for Medicare and Medicaid Services and the National Endoscopic Database. Gastrointestinal Endoscopy, 67(3), 489–496.
- Gatto, N. M., Frucht, H., Sundararajan, V., Jacobson, J. S., Grann, V. R., & Neugut, A. I. (2003). Risk of perforation after colonoscopy and sigmoidoscopy: A population-based study. Journal of the National Cancer Institute, 95(3), 230–236. CrossRef
- Arizona Department of Health Services, Bureau of Public Health Statistics. (2007). Arizona behavioral risk factor survey data and layout. Retrieved November 10, 2008, from http://www.azdhs.gov/plan/brfs/data.htm
- Seeff, L. C., Richards, T. B., Shapiro, J. A., Nadel, M. R., Manninen, D. L., Given, L. S., et al. (2004). How many endoscopies are performed for colorectal cancer screening? Results from CDC’s survey of endoscopic capacity. Gastroenterology, 127(6), 1670–1677. CrossRef
- Mysliwiec, P. A., Brown, M. L., Klabunde, C. N., & Ransohoff, D. F. (2004). Are physicians doing too much colonoscopy? A national survey of colorectal surveillance after polypectomy. Annals of Internal Medicine, 141(4), 264–271.
- Zbidi, I., Hazazi, R., Niv, Y., & Birkenfeld, S. (2007). Colonoscopy screening and surveillance of colorectal cancer and polyps: Physicians’ knowledge. The Israel Medical Association Journal, 9(12), 862–865.
- Boolchand, V., Olds, G., Singh, J., Singh, P., Chak, A., & Cooper, G. S. (2006). Colorectal screening after polypectomy: A national survey study of primary care physicians. Annals of Internal Medicine, 145(9), 654–659.
- Ransohoff, D. F. (2005). Have we oversold colonoscopy? Gastroenterology, 129(6), 1815. CrossRef
- Cotterill, M., Gasparelli, R., & Kirby, E. (2005). Colorectal cancer detection in a rural community. Development of a colonoscopy screening program. Canadian Family Physician, 51, 1224–1228.
- Newman, R. J., Nichols, D. B., & Cummings, D. M. (2005). Outpatient colonoscopy by rural family physicians. Annals of Family Medicine, 3(2), 122–125. CrossRef
- Edwards, J. K., & Norris, T. E. (2004). Colonoscopy in rural communities: Can family physicians perform the procedure with safe and efficacious results? Journal of the American Board of Family Practice, 17(5), 353–358. Review. CrossRef
- Kellerman, S. E., & Herold, J. (2001). Physician response to surveys. A review of the literature. American Journal of Preventive Medicine, 20(1), 61–67. CrossRef
- Hall, S. A., Kaufman, J. S., & Ricketts, T. C. (2006). Defining urban and rural areas in U.S. epidemiologic studies. Journal of Urban Health, 83(2), 162–175. CrossRef
- Rural–Urban Differences in Colorectal Cancer Screening Capacity in Arizona
Journal of Community Health
Volume 34, Issue 6 , pp 523-528
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Colorectal cancer
- Rural health
- Urban health
- Author Affiliations
- 1. Salt Lake City Veterans Affairs Health Care System, University of Utah, 500 Foothill Drive, Salt Lake City, UT, 84148, USA
- 2. Mel and Enid Zuckerman College of Public Health, Arizona Cancer Center, University of Arizona, 1515 North Campbell Avenue, Tucson, AZ, 85724, USA
- 3. New Mexico VA Health Care System, Department of Medicine, University of New Mexico, School of Medicine, Mailstop 111, 1501 San Pedro Drive South, Albuquerque, NM, 87108, USA
- 4. Department of Gastroenterology and Hepatology, Mayo Clinic, 13400 E Shea Boulevard, Scottsdale, AZ, 85259, USA
- 5. Mel and Enid Zuckerman College of Public Health, Arizona Cancer Center, Department of Medicine, University of Arizona, 1515 North Campbell Avenue, Tucson, AZ, 85724, USA