The results showed several interesting findings. Breast cancer patients in urban communities were diagnosed more often with non–invasive breast cancer than patients living in rural areas. This important finding may have several explanations including access and availability to screening, or ability to obtain or interpret biopsies in rural areas. Further studies will need to clarify this finding. Moreover, breast cancer patients in urban areas also had more sentinel lymph node (SLN) procedures than their rural counterparts. The SLN procedure was diffusing into the community from major teaching institutions in NNE and replacing the previous standard of regional lymph node dissection during this time. The ability to capture community acceptance/expertise of a new therapy, i.e. SLN, over time is also an important finding. It would be interesting to see how rapidly this (and other) new technologies are accepted and utilized in the rural community setting. Breast cancer patients undergoing SLN also received more post lumpectomy radiation therapy (RT) than patients who did not receive SLN. Even though no geographical variation between rural and urban areas was discerned, it would suggest that patients with access to a new technology also had easier access to RT. Defining variations in access to care therefore may be better measured if we looked at the difficulty patients may have in getting to the institutions where the care is delivered (i.e. driving times). The same issue was found to be true in colon cancer patients. Post operative chemotherapy is usually recommended in patients with Stage III colon cancer. A significantly higher proportion of patients received this adjuvant chemotherapy in urban rather than rural areas. The significance of these findings will require further testing and evaluation.