Implementing a Cancer Screening Patient Registry in an Urban Student-Run Free Clinic: A Model for Preventive Care...

Despite national guidelines promoting early cancer detection, adherence to screening recommendations remains below the USPSTF Healthy People 2030 targets. Nationally, only 71.8% of eligible adults receive colorectal cancer (CRC) screenings and 75.9% receive breast cancer (BC) screenings. Rates are significantly lower in uninsured or low-income populations, with just 7.5% and 35% receiving CRC and BC screenings, respectively. To improve presentation care delivery, a patient registry was developed at an urban, student-run free clinic serving the uninsured to track CRC and BC eligibility and screening orders. Baseline screening rates were identified through a retrospective chart review of clinic patients seen from 2021 to 2023. Process mapping was used to identify failure points in the screening workflow. A patient registry was implemented over 15 months (January 2024-March 2025) to monitor eligibility and increase screening order rates. Data collection focused on the proportion of eligible patients with appropriate screening orders placed. Average screening rates for CRC and BC prior to intervention were 18.3% and 12.6%, respectively. Following the implementation of the patient registry, rates increased to 34.4% for CRC and 30.3% for BC. The improvement in CRC screening was statistically significant, while BC screening showed early signs of positive change. Targeted identification of screening-eligible patients, regardless of visit reason, improves screening order rates. This approach may promote earlier cancer detection and improved outcomes. It is cost-effective, replicable, and adaptable to other chronic condition monitoring in student-run free clinics.