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We find that no pancreatic patients living in completely rural areas were diagnosed at the local stage, the lowest of all categories of rurality. In adjusted models, we find that patients living in completely rural areas have significantly lower rates of local and local/regional stage of diagnosis. The estimates are attenuated slightly when controlling for MUA. We find significantly lower rates of early stage pancreatic cancer diagnosis for patients living in completely rural areas. While lack of primary medical care resources is an imp