There is evidence that early cancer detection and treatment can significantly improve health outcomes, but women in Mississippi, especially in underserved populations, experience the worst health outcomes from cervical, breast, and oropharyngeal cancers.
A new paper by Michelle Williams, Associate Professor in the College of Health and Human Services Department of Global and Community Health at George Mason University, published in Journal of Cancer Awareness evaluates the ability to offer free cancer screenings and health education on the same day to reduce disparities in “preventable cancers”. Williams assessed the impact of having access to free mammograms, Pap tests, and pelvic exams, as well as oral cancer screening, on participants’ knowledge of cancer, self-efficacy in receiving health care, and intent to change their health behaviors.
Williams and colleagues evaluated an implementation of the See, Test, & Treat program, an evidence-based program developed by the College of American Pathologists (CAP) Foundation and adapted for use with uninsured and underserved women in the Jacksonville metropolitan area. See, Test & Treat participants were educated about cancer screening during their consultation with providers. Important features of the See, Test, & Treat program were that the participants received screening results within 2 hours and participants who received abnormal results could arrange a follow-up appointment at a federally qualified health center (FQHC) before their departure. Additionally, upon arrival at the screening site’s waiting room, attendees were able to choose from a variety of health activities, including healthy food demonstrations, yoga, and Zumba.
Cancer screening is a valuable tool for the early detection of cancer – however, uninsured and underserved women may not have access to routine life-saving checkups. The evaluation of the implementation of this program helps to show that it is feasible to give vulnerable populations access to free cancer screenings and to have the results available on the same day. “
Michelle Williams, Associate Professor in the College of Health and Human Services Department of Global and Community Health at George Mason University
The majority of participants said they took part in the See, Test & Treat program because they wanted a free cancer check-up and could get the test results back on the same day. The majority of participants said the program had a positive impact on their knowledge of cancer screenings and their self-efficacy in finding regular check-ups. In addition, participants reported that health education activities had a significant impact on their understanding of the cancers they were screened for, as well as health, diet, and exercise.
Follow-up appointments were made for all participants who received abnormal test results, including 18 women who received abnormal mammography results. 15 of the 18 women received a diagnostic mammogram, three of which required biopsies. All biopsy results were benign. Two of the women who received the oral cancer screenings had abnormal results and both were referred for treatment. None of the 44 Paps tested were abnormal, but 14 women were diagnosed with trichomonads and referred for treatment.
Overall, the program was positively received by the participants and successfully offered uninsured and underserved women free cancer screening and health education. When asked what they liked most about the program, participants said that the same day screening results were practical and that the staff treated them with respect. One participant reported that the staff “didn’t make me feel like someone without health insurance”. One of the limitations of the evaluation approach is the lack of long-term follow-up as the evaluation survey was conducted anonymously. William is keen to include an interview and a follow-up survey of all participants in future iterations of the program.
Participants learned about the program through advertisements distributed through channels such as churches, health centers, and social media. Childcare was offered for participants with small children. The American Cancer Society guidelines were used to determine eligibility for breast and cancer screening. 72 women met the admission requirements, 53 women were screened and 52 participants took part in the evaluation survey.
Williams initially led program evaluation at the University of Mississippi Medical Center’s (UMCC) Cancer Center and Research Institute and will continue her evaluations at George Mason University. Program evaluation is funded by the College of American Pathologists (CAP) Foundation.
Williams, MS, et al. (2021) The See, Test & Treat program of the College of American Pathologists Foundation®: An evaluation of a one-day cancer screening program conducted in Mississippi. Journal of Cancer Education. doi.org/10.1007/s13187-021-02060-9.