{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T08:36:42Z","timestamp":1786437402944,"version":"build-2736575974"},"reference-count":18,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Clin Cancer Inform"],"published-print":{"date-parts":[[2025,11]]},"abstract":"\n PURPOSE<\/jats:title>\n We developed and validated a dual-purpose, open-access Rural-Urban Commuting Area (RUCA) tool to standardize geographic coding for cancer disparities research, addressing National Institutes of Health (NIH) Helping to End Addiction Long-term (HEAL) Initiative Common Data Element requirements while supporting institutional catchment area analyses.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n This web-based tool\n \n 16<\/jats:xref>\n <\/jats:sup>\n integrates US Department of Agriculture RUCA codes with census tract data and electronic health record systems, meeting NIH HEAL Initiative Findable, Accessible, Interoperable, and Reusable (FAIR) data ecosystem requirements. We implemented the tool using Wake Forest Cancer Center's 2023 registry data (n = 21,219) and conducted systematic comparison with county-level Rural-Urban Continuum Code (RUCC) classifications using 18,714 cancer cases across 336 ZIP codes, focusing on breast, colon, and lung cancers to demonstrate enhanced geographic granularity.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Among 21,219 patients with cancer, 19.51% (n = 4,140) resided in rural areas, with 4.81% (n = 1,022) in the most rural census tracts (RUCA codes 7-10). Comparative analysis revealed 9.4% disagreement between RUCA and RUCC classifications, affecting 1,765 patients. Twenty-eight ZIP codes classified as rural by RUCA were located within metropolitan counties according to RUCC, encompassing 109 patients with cancer who would be misclassified using county-level measures. As a separate use case, integration with NIH HEAL Initiative standardized rurality data collection across 15 research studies.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n The RUCA tool addresses critical gaps in geographic data standardization by providing census tract-level precision that county-level classifications miss. This dual-application framework aligns institutional catchment analyses with national standardization efforts, identifying 109 patients with cancer who would be misclassified as urban residents using traditional county-level approaches, thereby enhancing targeted interventions for rural cancer care access.<\/jats:p>\n <\/jats:sec>","DOI":"10.1200\/cci-25-00122","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T21:00:16Z","timestamp":1762549216000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":2,"title":["Leveraging the Rural-Urban Commuting Area Tool to Address Geographic Disparities in Cancer Care: A Dual-Application Framework for Institutional and National Initiatives"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3969-4279","authenticated-orcid":true,"given":"Meredith C.B.","family":"Adams","sequence":"first","affiliation":[{"name":"Wake Forest University School of Medicine, Winston-Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3374-3754","authenticated-orcid":true,"given":"Cody L.","family":"Hudson","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine, Winston-Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4127-2213","authenticated-orcid":true,"given":"Matthew L.","family":"Perkins","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine, Winston-Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6591-9390","authenticated-orcid":true,"given":"Robert W.","family":"Hurley","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine, Winston-Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3241-8773","authenticated-orcid":true,"given":"Umit","family":"Topaloglu","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine, Winston-Salem, NC"},{"name":"National Cancer Institute, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/OP.20.00174"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-22-0173"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-017-0850-0"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-010-1457-z"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-21-1230"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1200\/OP.20.00352"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkac083"},{"key":"e_1_3_8_9_2","unstructured":"National Cancer Institute: National Cancer Institute GIS portal for cancer research. https:\/\/gis.cancer.gov\/"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnae110"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnad018"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/29767342241236287"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djac030"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.1061"},{"key":"e_1_3_8_15_2","first-page":"78","article-title":"Same people, different results: Categorizing cancer registry cases across the rural-urban continuum","volume":"123","author":"Schiefelbein AM","year":"2024","unstructured":"Schiefelbein AM, Krebsbach JK, Taylor AK, et al: Same people, different results: Categorizing cancer registry cases across the rural-urban continuum. WMJ 123:78-87, 2024","journal-title":"WMJ"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16061076"},{"key":"e_1_3_8_17_2","unstructured":"RUCA Tool Website: ruca.wakehealth.edu"},{"key":"e_1_3_8_18_2","unstructured":"RUCA Zip Search Tool Setup Instructions: github.com\/mlperkin\/ruca"},{"key":"e_1_3_8_19_2","unstructured":"RUCA Application Programming Interface (API) Setup Instructions: github.com\/mlperkin\/ruca-api"}],"container-title":["JCO Clinical Cancer Informatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/CCI-25-00122","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T21:00:19Z","timestamp":1762549219000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/CCI-25-00122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":18,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1200\/CCI-25-00122"],"URL":"https:\/\/doi.org\/10.1200\/cci-25-00122","relation":{},"ISSN":["2473-4276"],"issn-type":[{"value":"2473-4276","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-04-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-10","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2500122"}}