Care in the Community: Opportunities to improve cancer screening uptake for people living with low income

Addressing Cancer Disparities Through Community Engagement: Lessons and Best Practices

Cancer disparities continue to be a significant public health challenge, disproportionately affecting certain communities in terms of incidence, mortality, and access to quality care. Addressing these disparities requires a multifaceted approach that involves not only healthcare professionals and researchers but also the active participation and collaboration of the affected communities themselves. Community engagement has emerged as a promising strategy to reduce cancer disparities and promote health equity. This review article synthesizes the existing literature and examines the role of community engagement in addressing cancer disparities. It explores various approaches and best practices utilized in community engagement initiatives to empower and involve diverse populations in the fight against cancer. The review discusses key lessons learned from successful programs and identifies challenges faced in implementing such initiatives. The article highlights the importance of cultural competence, trust-building, and meaningful collaboration between stakeholders, including community leaders, healthcare providers, researchers, and policymakers. It emphasizes the significance of tailoring interventions to specific community needs, acknowledging cultural differences, and fostering a two-way exchange of knowledge and resources. Moreover, this review investigates the impact of community engagement on cancer prevention, early detection, treatment adherence, and survivorship outcomes. It sheds light on the role of community-based participatory research and other innovative strategies in generating evidence and facilitating the translation of research findings into real-world interventions. In conclusion, this review underlines the potential of community engagement in addressing cancer disparities and promoting health equity. By involving communities as active partners in cancer control efforts, healthcare systems can design more effective and sustainable interventions. This approach not only contributes to reducing cancer disparities but also fosters a sense of ownership and empowerment within the communities affected, paving the way for a more equitable and inclusive healthcare landscape.

Widening the offer of human papillomavirus self-sampling to all women eligible for cervical screening: Make haste slowly

Self-collection of samples for human papillomavirus (HPV) testing has the potential to increase the uptake of cervical screening among underscreened women and will likely form a crucial part of the WHO's strategy to eliminate cervical cancer by 2030. In high-income countries with long-standing, organised cervical screening programmes, self-collection is increasingly becoming available as a routine offer for women regardless of their screening histories, including under- and well-screened women. For these contexts, a validated microsimulation model determined that adding self-collection to clinician collection is likely to be cost-effective on the condition that it meets specific thresholds relating to (1) uptake and (2) sensitivity for the detection of high-grade cervical intraepithelial neoplasia (CIN2+). We used these thresholds to review the 'early-adopter' programme-level evidence with a mind to determine how well and how consistently they were being met. The available evidence suggested some risk to overall programme performance in the situation where low uptake among underscreened women was accompanied by a high rate of substituting clinician sampling with self-collection among well-screened women. Risk was further compounded in a situation where the slightly reduced sensitivity of self-sampling vs clinician sampling for the detection of CIN2+ was accompanied with lack of adherence to a follow-up triage test that required a clinician sample. To support real-world programmes on their pathways toward implementation and to avoid HPV self-collection being introduced as a screening measure in good faith but with counterproductive consequences, we conclude by identifying a range of mitigations and areas worthy of research prioritisation.