Pignone Michael
Durham, NC.
Trans Am Clin Climatol Assoc. 2025;135:157-168.
Cancer remains a leading cause of mortality in the United States, with significant inequities across racial and ethnic groups. Evidence-based cancer screening and prevention offers one pathway to reducing cancer mortality but can be challenging to implement with high fidelity and equity. In this paper, we describe the development of equitable, evidence-based cancer screening programs in Central Texas as a potential model for other regions and for other conditions for which evidence-based clinical preventive services exist but are not well-implemented or have not been implemented equitably. Key features include basing the program in Federally Qualified Health Centers (FQHCs); developing proactive outreach along with opportunistic in-reach; bilingual, bicultural social work-trained patient navigators for follow-up of abnormal screening; virtual multi-disciplinary conferences for challenging diagnostic and management decisions; and advocacy work to improve the entire screening process, including treatment.
癌症仍然是美国主要的死亡原因，不同种族和族裔群体之间存在显著的不平等。基于证据的癌症筛查和预防是降低癌症死亡率的一条途径，但要以高保真度和公平性来实施可能具有挑战性。在本文中，我们描述了德克萨斯州中部公平、基于证据的癌症筛查项目的发展情况，将其作为其他地区以及存在基于证据的临床预防服务但实施效果不佳或未公平实施的其他情况的潜在模式。关键特征包括：以联邦合格健康中心（FQHCs）为项目基础；开展主动外展以及机会性内展；配备经过双语、双文化社会工作培训的患者导航员，用于跟进异常筛查；召开虚拟多学科会议，以应对具有挑战性的诊断和管理决策；以及开展宣传工作，以改善包括治疗在内的整个筛查过程。
