In a presentation at the 2023 NCCN Annual Conference, Keith Argenbright, MD, director of the Moncrief Cancer Institute in Fort Worth, TX, and Evelyn González, senior director of community outreach at Fox Chase Cancer Center in Philadelphia, PA, described the benefits of mobile cancer screening programs for underserved populations and reviewed factors to consider for successful implementation of these programs. 
 
Research has shown that breast cancer has a high percentage of cure rate when it’s discovered early, and mammograms can help diagnose breast cancer in its early stages, when it’s most treatable. Mobile screening clinics are an effective tool to increase the access patients have to early screening for breast cancer and other cancers. According to Dr Gonzalez, 47% of women screened by Fox Chase Cancer Center’s mobile screening unit stated that they would not have gotten a mammogram if not for the mobile screening program.
 
Moncrief Cancer Institute’s ADA-compliant mobile screening unit (MSU) performs 125 mobile screening events annually and has traveled more than 117,000 miles to reach underserved communities in need of increased access to cancer screening. It offers 3D mammography machines for breast screening and diagnosis, and the clinic also provides Papanicolaou tests to screen for cervical cancer and blood tests to screen for prostate cancer, all performed in private exam rooms. 
 
The MSU was obtained through a Section 1115 waiver Medicaid grant. Dr Argenbright explained that grant funding for the screening programs allows for centralized reimbursement and expedited care to patients in the event of an abnormal screening result. Even though it’s a complex process, their current loss to follow-up rate is under 2%, and their average time from presentation to diagnosis is 22 days in these underserved populations.
 
Dr Argenbright also stressed the importance of community outreach and engagement to build partnerships and establish trust with stakeholders who may be concerned about the cost of these programs. “When I say it’s not going to cost you anything, that’s when they begin to listen,” Dr Argenbright said. Establishing trust with patients, health care providers, and community partners is essential to the mobile screening clinics being accepted into and embraced by communities that are often rural and underserved. “We have to assure our health care providers that we’re not there to steer patients back to our academic medical center,” he said. 
 
Setting up a new program requires adequate data around cancer burden by geographic region to guide decision making. This data can be found through internal institution data and national standards. Identifying partners, both traditional (eg, churches or community-based organizations) and nontraditional (eg, rotaries or Federally Qualified Health Centers), is a key step in gaining community support. Frequent and robust reporting of data to senior leadership and finance departments is crucial for maintaining funding from grants. 
 
Dr Gonzalez discussed additional factors to consider when advocating for a mobile screening program at a cancer center, including being able to show the business strategy, creating an organizational culture that is integrated with the structure of the cancer center overall, and fostering community engagement in the potential program. 
 
From a patient perspective, challenges for accessing mobile screening programs include being underinsured, not having adequate transportation, and experiencing language and literacy barriers. On the health care provider side, challenges for implementation include encountering high no-show rates in the community, not accepting patients’ insurance, and not being able to easily show return on investment.  
 
Future plans to expand mobile breast cancer screening include bringing the clinic to where women work. “Workplaces are very interested in being able to offer this to their employees, especially post-pandemic,” Dr Argenbright said. The next generation of mobile screening units will expand the types of screening they can provide, including cervical, colorectal, skin, anal, prostate, and liver cancer screening, as well as biospecimen collection. 
 
Source:
 
Argenbright K, González E. Mobile Screening Programs: Improving Patient Access to Oncology Care. Presented at: 2023 NCCN Annual Conference; Mar 30-Apr 2, 2023; Orlando, Florida, and virtual.