Community-directed cancer screening program.

The Atlanta Project, one of six American Cancer Society demonstration projects, is a community-designed and -directed breast and cervical cancer screening program focused on empowering African-American women to accept responsibility for their health maintenance. This article reports the project's goals, objectives, intervention strategies, roles of key project personnel, and outcomes. A total of 3852 women older than 40 years received breast clinical examinations, were taught breast self-examination, and had a screening mammogram; 2689 women obtained a pelvic examination and were screened for cervical cancer with a Papanicolaou smear. Of those women screened, 12 breast and 1 cervical cancers were identified and treated. Important lessons learned and successes achieved from this project were: (1) there is a need for joint planning with community representatives and their involvement in all aspects of the program's implementation and evaluation; (2) in addition to the commitment of the major participants, the community must "buy in" to the proposed health intervention; (3) the focus of the intervention should be on positive health messages; (4) cancer education materials should be culturally and literacy-appropriate; (5) the project's activities were planned to be sustained after the project period; (6) women can be empowered to accept responsibility for and control over their health.