Original Paper

Journal of Community Health

, Volume 34, Issue 6, pp 523-528

First online:

Rural–Urban Differences in Colorectal Cancer Screening Capacity in Arizona

  • Jose G. BenuzilloAffiliated withSalt Lake City Veterans Affairs Health Care System, University of Utah
  • , Elizabeth T. JacobsAffiliated withMel and Enid Zuckerman College of Public Health, Arizona Cancer Center, University of Arizona
  • , Richard M. HoffmanAffiliated withNew Mexico VA Health Care System, Department of Medicine, University of New Mexico, School of Medicine
  • , Russell I. HeighAffiliated withDepartment of Gastroenterology and Hepatology, Mayo Clinic
  • , Peter LanceAffiliated withMel and Enid Zuckerman College of Public Health, Arizona Cancer Center, Department of Medicine, University of Arizona
  • , María Elena MartínezAffiliated withMel and Enid Zuckerman College of Public Health, Arizona Cancer Center, University of Arizona Email author 

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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.


Colorectal cancer Screening Capacity Rural health Urban health