Cervical Cancer Screening Collaborations Between National Cancer Institute Cancer Centers and Safety-Net Settings of...

Supporting medically underserved and socially disadvantaged populations, particularly in relation to cervical cancer, requires identifying coordination gaps. However, approaches to address the cervical cancer screening process between cancer centers and safety-net settings of care (hereinafter, safety-net settings) are poorly understood. We describe interactions and identify opportunities to guide cancer centers that aim to strengthen cervical cancer prevention, screening, and treatment for patients referred to them from safety-net settings.

We administered a 15-item online survey from January 12 through February 9, 2022, to National Cancer Institute (NCI) cancer centers; the intended audience was associate directors of community outreach and engagement and/or associate directors of population sciences. Of 64 eligible cancer centers, 47 (73.4%) completed the survey; however, 7 cancer centers were excluded from analysis because they reported not having a formal arrangement with safety-net settings. We developed survey items in consultation with subject matter experts and conducted pilot testing before administration to sites.

The most common forms of partnership between NCI cancer centers and safety-net settings were referrals and consultations (34 of 40; 85.0%). We identified multilevel barriers affecting coordination and follow-up of abnormal cervical cancer screening test results. Communication between safety-net settings and cancer center staff was the most reported systems-level challenge to care coordination (35 of 40; 87.2%). Collection and synthesis of patient data presented the primary systems-level challenge to following up to abnormal cancer screening (34 of 40; 85.0%).

Collaborations between cancer centers and safety-net settings are common but limited by challenges in care delivery and coordination. Our findings underscore the importance of identifying intervention points to optimize the management of cervical cancer care for patients in safety-net settings.