Multi-modal approach to secondary cancer prevention: Norton Cancer Institute Prevention and Early Detection Program

Background: Cancer mortality rates in Louisville (Jefferson County), Kentucky are among the highest in the nation. We sought to reduce barriers to screening and prevention services through implementation of a mobile health unit, focusing on the medically underserved and building on an infrastructure that provides access to diagnostic and treatment services regardless of ability to pay.

Methods: Our multi-modal approach included utilization of a Mobile Prevention Center equipped to provide clinical breast exams, mammograms, Pap smears, Prostate exams and PSA blood tests. We also utilized community outreach workers, medical providers and a nurse navigator to facilitate follow-up services.

Results: The Norton Cancer Institute Prevention and Early Detection Program screened 1817 people in 2008, a 330% increase compared to 2007. A total of 42% of the men and women were uninsured at the time of the screening and 38% of the patients resided in high risk areas. Our community outreach workers used culturally appropriate outreach education and strategies to reach approximately 20,000 men and women and conducted 2,000 cancer risk assessments at health fairs, seminars, and community events throughout the Louisville region. Adherence to follow up was more than 93% with the nurse navigator.

Conclusions: Our multi-modal approach was successful in reducing barriers to cancer screenings and in screening medically underserved men and women in Louisville, Kentucky.