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The American Cancer Society's (ACS) National Consortium for Cancer Screening and Care last week released a report outlining nine recommendations to restore cancer screening rates back to pre-pandemic levels.
Case study: 9 innovative strategies to improve cancer screening
1. Prioritize collaboration between stakeholders
To influence the adoption of evidence-based cancer screening policies, ACS recommends prioritizing and accelerating partnerships, coalitions, and roundtables.
In particular, it suggests connecting organizations and cataloging resources, facilitating an increase in evidence-based practices and new research findings in both clinical and community settings, and fostering sustainable collaboration among national roundtables.
2. Form coordinated and innovative campaigns to encourage screening
To promote cancer screening as a public health priority, ACS recommends creating coordinated, innovative campaigns that target improved screening policies.
When forming a campaign, it suggests using targeted messaging on contemporary platforms that can effectively inform populations most vulnerable to cancer. Campaigns should encourage customization from participating organizations to assess and meet the needs of their target population.
In addition, it suggests understanding and utilizing target populations' trusted media channels to deliver health information. Ultimately, it advises that campaigns should aim to develop and deliver cancer messaging that is understandable, meaningful, and usable.
3. Take advantage of proven community-based programs
To accelerate screening efforts, ACS suggests supporting and expanding proven community-based programs that effectively reach historically excluded and underserved communities.
In particular, it advises advocating for financial reimbursement of patient navigation programs within health systems and community health worker programs within communities.
It also suggests implementing effective patient navigation and community health worker models in underserved communities while improving support and training for health care workers in those areas.
Further, it suggests promoting partnerships between health systems and community programs to improve access to clinical services and improve patient outcomes overall.
4. Implement improved quality and accountability measures
ACS suggests adopting improved quality measures, accountability measures, and institutional goal-setting metrics that prioritize health equity.
In addition, it suggests adopting quality measures that closely monitor on-time screening and follow-up care. It also recommends using national health standards for accreditation of cancer screening institutions.
According to ACS, health systems should also be required to report outcomes by key demographic and disparity factors, including insurance status, race/ethnicity, sexual orientation, and gender identification.
5. Utilize pandemic-related innovations and interventions
To accelerate innovations and interventions that can expand equitable access to cancer screening and treatments, ACS suggests steering screening conversations to mitigate fears and misinformation. It also recommends improving access to preventive care, using community tracing technology and staffing from the pandemic for cancer screening, and improving the integration and adoption of technology.
6. Adopt a whole-person approach to increase trust in public health and health care systems
To strengthen trust in public health and health care systems, ACS suggests using a forward-looking, whole-person approach.
When integrating a whole-person approach, health systems should include multiple health care disciplines. For instance, in addition to health care providers, behavioral health experts, community health workers, and navigators should also be involved in cancer prevention, screening, and care interventions.
To better understand medical mistrust, ACS suggests conducting community-based participatory research and using the findings to change organizational policies and practices, inform health care providers and professionals, and adjust messaging to reach apprehensive communities.
7. Include cancer and other chronic disease care in preparedness plans
To strengthen both health system and community preparedness plans for health disruptions, ACS suggests including cancer care and chronic disease care in the plans.
According to ACS, every health care organization should delegate a champion to design a preparedness plan that includes cancer needs with a goal to minimize care disruptions.
Health care organizations should also aim to create preparedness plans that encompass all individuals within a community. In addition, they should work to establish open lines of communication with the community—a measure that will help ensure that trust will be maintained and strengthened during future public health emergencies, according to ACS.
8. Track and understand cancer disparities
To strengthen understanding of outcomes in cancer screening and care, ACS suggests collecting and aggregating demographic and social determinants of health data.
In particular, it suggests establishing best practices for data collection and utilization and providing training to the individuals who collect the data.
9. Support transdisciplinary teamwork
To improve health care delivery, ACS suggests strengthening transdisciplinary teamwork.
ACS suggests coordinating connections between interdisciplinary health care teams by creating opportunities for collaboration between teams that do not normally work together.
"Build respectful spaces for conversations and reconnection between health care and public health professionals, community leaders, and community/patient populations. National, state, and local partners should work together to disseminate tools that emphasize approaches informed by implementation science," ACS writes. (ACS Recommendations to Improve Cancer Screening and Care report, 2/16; Carbajal, Becker's Hospital Review, 2/21)
3 priorities for your cancer screening program
By Deirdre Saulet, Expert Partner
These nine recommendations are a fantastic jumping off point to prioritize and drive screening volumes across the country. Of course, producing meaningful results will require time, investment, and commitment from several stakeholders across the entire health care system and the communities they serve. To ensure progress, three priorities come to mind:
- Seek strategic partnerships with aligned stakeholders. Partnerships are undoubtedly critical to driving cancer screening. But all too often partnerships are ineffective or, even worse, do more harm than good for involved partners and communities they're meant to serve. Instead, we need to build partnerships that outline clear roles and responsibilities and outcomes—and do so sustainably. And rather than falling into old habits, leaders should think creatively about who they're partnering with and how they're partnering. For instance, working with competitors in your market may help drive consistent messaging to your community and produce outsized results.
- Center the community and what it needs—rather than what you think it needs. A key player in driving meaningful screening initiatives is the community—especially those communities experiencing disparities in screening access, adherence, and outcomes. But all too often, stakeholders speak on behalf of marginalized groups, rather than actively engaging them to understand root causes and surface effective solutions. I've found myself going back again and again to this article, which is a must-read on how to "listen with your ears, not with your eyes." If we commit to centering the community in these efforts, my hope is that we just won't bring screening back, but we will use this opportunity to reinvent screening programs to address racial disparities and reach people in need.
- Prioritize data collection and quality measurement—but don't let it stymie progress. The taskforce's recommendations underscore how critical data is to understand status quo, identify inequities and gaps in screening, and track progress. This unquestionably needs to be a national priority, but, in the meantime, imperfect data is still a start. Something is better than nothing, and there is often enough evidence both at the organizational and national level to at least get started, rather than becoming overwhelmed with the sheer amount of data to sift through.
If we are to make the most of what we learned across the pandemic and these recommendations, leaders across the oncology industry need to be committed to sharing what they are learning, hearing, experimenting with, and where they’re finding success—and failure.
To get started, learn how your peers are using innovative strategies to improve cancer screening.
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