Urban–Rural Disparities in Access to Low-Dose Computed Tomography Lung Cancer Screening in Missouri and Illinois
ORIGINAL RESEARCH — Volume 17 — November 5, 2020
PEER REVIEWED
This 2-panel figure maps degree of rurality at the census tract level (through rural–urban commuting area codes) and at the county level (through National Center for Health Statistics rural–urban classification codes). Metropolitan areas are located primarily in and around Chicago, St. Louis, and Kansas City, as well as in central Illinois and central and southwest Missouri. Micropolitan and rural areas are found mostly in southern Illinois and Missouri as well as northern Missouri and western Illinois.
Figure 1.
Measures of rurality in Missouri and Illinois and location of low-dose computed tomography screening centers. A, Rural–urban commuting area (RUCA) categories at the census tract level, determined by US Department of Agriculture Economic Research Service (16). B, National Center for Health Statistics (NCHS) rural–urban classification codes at the county level (17). Data on screening centers obtained from American College of Radiology (11) and GO2 Foundation for Lung Cancer (12). Shapefiles obtained from ESRI (20).
This 3-panel figure maps access to lung cancer screening, lung cancer mortality, and smoking prevalence at the county level. The Chicago, St. Louis, and Kansas City metropolitan areas all have good access to lung cancer screening, as do much of central Illinois and Missouri. Counties with high lung cancer mortality are concentrated primarily in southern Illinois and southeastern Missouri. Smoking prevalence is several percentage points higher throughout Missouri than in Illinois.
Figure 2.
Access to LDCT lung cancer screening, lung cancer mortality, and smoking prevalence in Missouri and Illinois. A, Percentage of residents aged 55–79 with access to an LDCT lung cancer screening center within 30 miles. B, Lung cancer mortality (deaths per 100,000) among adults aged ≥60. C, Adult smoking prevalence. All maps are at the county level, and categories are based on rounded quintiles. Data obtained from American College of Radiology (11), GO2Foundation for Lung Cancer (12), Surveillance, Epidemiology, and End Results program (18), and County Health Rankings (19). Shapefiles from ESRI (20). Abbreviation: LDCT, low-dose computed tomography.
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