Progress Toward Increasing Adherence to Cancer Screening Guidelines Multilevel and multipronged approaches are required to eliminate cancer health inequities across the continuum of care, including uptake and follow-up of recommended evidence-based cancer screening among all eligible individuals (see Sidebar 23, p. 64). Stakeholders across the cancer care continuum (see Sidebar 1, p. 13) are working together to achieve these goals. In the United States, the Community Preventive Services Task Force (CPSTF), established by the U.S. Department of Health and Human Services in 1996 at CDC, develops guidance on community-based health promotion and disease prevention. Based on the available scientific evidence, CPSTF periodically issues recommendations and findings on public health interventions designed to improve health and safety. As one example, CPSTF recently reviewed 34 studies evaluating the effectiveness of patient navigation in increasing cancer screening uptake among racial and ethnic minority populations and people with lower incomes (303). Based on the findings, CPSTF recommended in the 2022 Annual Report to Congress that patient navigation services should be provided to medically underserved communities to increase breast, cervical, and colorectal cancer screening (304). The Task Force concluded that patient navigation services advance health equity. Patient navigation also improves timely and appropriate follow-up care and treatment, and may improve health and reduce cancer-related disparities for the racial and ethnic populations and people with lower incomes who are medically underserved. Recognizing the critical importance of regular cancer screening in saving lives, the National Cancer Plan, released by NCI in April 2023, prioritizes early cancer detection and cancer prevention (309). The plan calls for new technologies and Only 28 percent of physicians surveyed reported having received training regarding cancer screening for patients belonging to sexual and gender minorities (302). Evidence-based Interventions to Increase Adherence to Cancer Screening According to the Centers for Disease Control and Prevention (CDC), evidence-based interventions are strategies that improve delivery of cancer screening and increase the number of people screened. Below are recent examples of some of the evidence-based interventions that have been shown to increase cancer screening adherence among eligible individuals: Combining tailored educational material with patient navigation An interactive video of tailored messages about cancer screening followed by a phone call with a patient navigator increased adherence to routine screening for breast, cervical, and colorectal cancers six times among women living in rural areas (305). Mailing self-collection sample kits Mailing human papillomavirus self-collection kits to women eligible for cervical cancer screening nearly doubled the screening uptake (306). Using digital interventions Using telemedicine as well as Internet- and mobile device-based technologies to help make informed decisions resulted in a 1.5 times increase in the completion rate for colorectal cancer screening (307). Implementing public health campaigns Clinics that participated in the Colorectal Cancer Control Program of CDC and applied a combination of three or more evidence-based interventions increased the uptake of colorectal cancer screening by five percentage points (308). SIDEBAR 23 AACR Cancer Progress Report 2023 Screening for Early Detection 64
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