In this supplement, we propose to expand our linkage of the Colorado Central Cancer Registry and the Colorado All Payer Claims Dataset to specifically consider areas of High and Persistent Poverty, Frontier and Remote Areas (FAR), and Health and Professional Shortage Areas (HSPAs) in Colorado. Data compiled from our parent grant can be uniquely used to inform what is known about patterns of disparities in these areas and provide insight about the future impact of cancer on the population. With the rise of the COVID pandemic, rural and frontier, low-income, and health shortage areas are the least prepared to meet emerging needs caused by the pandemic. Geographic disparities in cancer outcomes are considerable and continue to persist.
Geographically underserved areas refers to (1) areas and populations with high and/or persistent poverty, or (2) areas and populations living with high and/or persistent poverty in Health Professional Shortage Areas (HPSAs) or Frontier and Remote (FAR) area zip codes (definition and FAR codes can be found at: ). However, these populations in the ‘geographically underserved areas’ have previously not been a significant component of cancer control research. These issues are further exacerbated in areas lacking (or ineligible to qualify as HPSAs) health facilities designated by the Health Resources and Services Administration (HRSA) as HPSAs. In particular, people living in poverty have higher rates of cancers caused by occupational, recreational, or lifestyle exposures (e.g., colorectal, laryngeal, liver, lung) and by human papillomavirus infection (e.g., anal, cervical, oral). All these factors result in increased cancer incidence and delayed cancer diagnosis, treatment, and subsequently, lower rates of survival. Populations in poverty-in particular high poverty and/or persistent poverty (definition and map of persistent poverty counties in the United States can be found at: ) are at an increased risk of cancer due to greater carcinogen exposure, low educational attainment, lack of adequate housing, challenges accessing food and food insecurity, and the lack of access to care. Despite advances in cancer prevention, diagnosis, treatment and survival, disparities in cancer outcomes continue to persist with increased mortality among people living in poverty.
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