An ounce of "superscreener": A novel cancer screening program targeting unattached individuals

Cancer screening enables early detection, reducing morbidity, mortality, and healthcare costs. Canada's primary care crisis has left many individuals unattached, creating barriers to cancer screening and exacerbating disparities.  INTERVENTION: The Champlain Screening Outreach (CSO) program provided cancer screening to unattached individuals and underserved populations. CSO collaborated with public health, community health centers, and community organizations to increase engagement with typically underscreened populations. A nurse practitioner superscreener conducted screening consultations, ordered tests, and followed up on results. Data from the program's inaugural year were analyzed, including participation, test completion, high-risk referrals, and abnormal findings. Sociodemographic data characterized unattached and neverscreener populations.

In its first year, CSO conducted 527 consultations and facilitated 786 screening tests. High-risk referrals were significantly higher than provincial rates for colorectal (41.5% vs. 2.6%, p < 0.01) and breast cancer (27.3% vs. 1.1%, p < 0.01). Among participants, 195 (36.4%) were neverscreeners. Abnormal result rates were elevated across cancer types: cervical (5%), breast (13.1%), colon (28.1%), and lung (16.6%). FIT return rates (53.3%) were lower than the provincial average. CSO participants predominantly resided in lower-income neighborhoods with high immigrant and visible minority populations. Neverscreeners were more likely to experience neighborhood instability.

CSO effectively improved cancer screening access for unattached individuals and reduced screening disparities. Elevated rates of abnormal findings and high-risk referrals highlighted the importance of collaboration with community organizations to reach underscreened populations and the efficacy of targeted screening assessments. CSO's outcomes demonstrate its potential as a centralized, scalable, and proactive solution to enhance cancer screening equity and mitigate the impact of the primary care crisis.