Background: Cancer disparities in the United States exist among distinct community populations most notably categorized by geography, income level, and race/ethnicity, where higher cancer risk and worse outcomes persist. Although poverty is often associated with health disparities, impoverished rural communities are often overlooked and underrepresented in research studies, even in the most economically distressed areas in the nation. Rural counties frequently have worse cancer outcomes, and are Medically Underserved Areas (MUAs) and Health Professional Shortage Areas (HPSAs). Rural