Health care pros stress importance of early cancer screenings

Despite national recommendations and the elimination of out-of-pocket costs for many patients, a lot of people avoid cancer screening until something goes wrong — and by then their survival rate may be diminished. NJBIZ spoke with some New Jersey health care systems to see how they’re trying to get more people in earlier.

“At Atlantic Health, we’re taking a number of approaches,” said Dr. Eric Whitman, medical director of Atlantic Health System’s Oncology Service Line. “We’re focusing on getting the word out, along with emphasizing the role of primary care providers and early discovery. Our marketing department is coordinating many of the efforts.”

Lydia Nadeau, executive director of AHS’ Oncology Service Line noted that, “When patients see their primary care doctor, it’s like an early warning system, so we’re working with outside agencies and other organizations to educate people in underserved and other communities about how important this is.”

With the onset of COVID, “we saw a decline in the number of people making in-person visits to their doctor,” added Whitman. “But with more people getting vaccinated, there’s been a ‘V’ shaped recovery and more people are coming in, although from what we’ve seen — and heard anecdotally — the number of visits still hasn’t reached pre-COVID levels.” Atlantic Health takes additional steps to encourage screenings, like offering mammograms without a prescription, he noted.

Other health care providers also cited COVID as a screening concern.

Sobeida Santana-Joseph, director of oncology accreditations and special programs at Valley-Mount Sinai Comprehensive Cancer Care said, “We’ve made progress in getting more people in for cancer screenings since the COVID-19 pandemic, but there are challenges. In general, health care organizations are approaching pre-COVID volumes, but we’re not there just yet.”

Getting the word out

To engage communities and increase cancer screenings, Valley Health System has enhanced its educational and outreach programs. “Since 2020, we’ve increased our social media presence, and our marketing and community health department teams have created podcasts and videos to address the importance of cancer screening,” Santana-Joseph added. To make it more convenient, Valley Health established a Fast-Track Screening Colonoscopy program, “which streamlines the process of scheduling a colonoscopy procedure by eliminating the need for qualifying patients to meet with a gastroenterologist or colorectal surgeon for a pre-procedure appointment. Instead, patients meet the physician and physician assistant on the day of their procedure,” she noted. “We must approach early detection and prevention in a holistic manner,” Santana-Joseph observed. “We’ll effect change with cancer screening by eliminating barriers and focusing on continued education and outreach programs. We anticipate that in the future, personalized medicine and other advances will make screenings themselves more efficient.”

Still, “Today, we really can’t talk about any type of cancer screening without first acknowledging the negative impact the coronavirus pandemic has had on screening,” observed Jane White, vice president, Oncology at St. Joseph’s Health. “Beginning in March 2020, many screening facilities simply shut down in an effort to ‘flatten the curve’ and hospitals had to delay screenings, as well as some treatment procedures, in an attempt to re-deploy clinical resources, preserve limited personal protective equipment and reduce potential exposures to COVID-19.”

Using funds from the New Jersey Cancer Education and Early Detection (CEED) Program, “more than 1,500 patients were screened in 2021 for breast, cervical, and colorectal cancer,” she noted. “Additionally, 27 men received PSA screening for prostate cancer.”

White said she is also part of a newly formed Passaic County Cancer Task Force – which was brought together by Board of County Commissioners Director Bruce James – with representatives from hospital, community and church organizations to study county health disparities related to cancer and find concrete ways to improve access to quality care.

Other institutions are also using innovative outreaches, according to Dr. James Wurzer, medical director of the AtlantiCare Cancer Care Institute, a Fox Chase Cancer Center Partner; he’s also medical director of Radiation Oncology at AtlantiCare Regional Medical Center. “One initiative is to tie screenings, which admittedly may not be the most fun thing to do but are usually simple and fast, to enjoyable occasions,” he said. In addition to using a person’s birthday as a tie-in, “we have seen groups of women coming for their mammograms together and then going to lunch and spending the day together. They make taking care of themselves and each other a special experience.”

AtlantiCare also offers free screening events at locations like its Egg Harbor Township and Cape May Court House sites, periodically holding free screening and informational events.

Dr. Roshani Patel, from Hackensack Meridian Health’s Jersey Shore University Medical Center, is working on getting the New Jersey CEED Program for low-income patients launched at her facility, “as we have throughout New Jersey, and will work with the Booker Family Health Center to fast-track patients with breast issues for this program and also get all eligible patient signed up so the screens are covered for this patient population.”

Patel is also working with other breast surgery colleagues and Dr. Harriet Borofsky — Hackensack Meridian Health’s medical director of breast imaging at Riverview and Bayshore Medical Centers — in such outreach programs as presenting talks to educate local residents about early detection and “de-escalating” care. “We also would like to work with the VNA [Visiting Nurse Association] and other organizations to give talks in the community — although COVID has been a barrier.”

Early cancer-screening adoption rates are not quite where providers would like them to be, but that’s not stopping dedicated professionals at these and other institutions from trying to improve the numbers.

Hospitals go mobile

Dr. Arkady Broder, chief of the division of gastroenterology and hepatology at Saint Peter’s University Hospital specializes in colorectal cancer, and said Saint Peter’s uses community outreach and other programs to try to up the number of screenings.

“We’ve got a mobile health van staffed with nurses and other hospital professionals who offer basic screenings like taking blood pressure and glucose reads,” he explained. “And we’re working on bringing more comprehensive point of care screening to the community. We also hold community-wide educational events—like ‘Walk with a Doc’ in Middlesex County — to promote screening.”

But more action, “especially at the federal level, is needed,” he said, including education, and ensuring that at-risk individuals have access to proper screening and medical care. “Our efforts, though, seem to be working and it is gratifying to see we’re projected to screen more than 4,000 local residents during 2022, which is about where we were pre-COVID.”

Englewood Health has made a commitment to tackling health care disparities that leave communities vulnerable to missing important screenings, according to Dr. Steven Brower, medical director of the institution’s Lefcourt Family Cancer Treatment and Wellness Center. “In recent months, we’ve hosted free screening events at our Urgent Care centers in Cresskill, Fair Lawn, Jersey City and Englewood,” he said. “Additionally, we’ve conducted targeted outreach efforts, including to the local Korean American community—many of whom face socioeconomic barriers to receiving cancer screenings.”

Englewood Health’s population health team “is dedicated to improving health outcomes and expanding access to services across northern New Jersey,” he added. “This team partners with community-based organizations, such as community centers, food banks, houses of worship, and schools, to reach those in need and get them in for recommended screenings. We’ve also expanded the ways people can get screened outside the four walls of our hospital. People across northern New Jersey can get screened at one of our conveniently located imaging sites.”

The most recent site to open is Englewood Hospital Imaging at Fair Lawn, a location that makes advanced imaging services easier to access for residents of western Bergen County and Passaic County.

Other health care institutions have staked out their own approaches. At CentraState, “we are doing three things to increase the number of cancer screenings for the community we serve,” explained Dr. Alexander Itskovich, medical director at The Statesir Cancer Center at CentraState. “First, we continue to educate people about the importance of screenings and risk factors. Second, we are adding additional types of cancer screenings, many of which are very simple and non-invasive. And third, we are making screenings more convenient to access,” with initiatives like no-prescription routine mammograms for women over 40 who qualify and do not have any symptoms.

Virtua Health is also making it easier to get several kinds of cancer screenings, according to Dr. Matthew Puc, program director of the Penn Medicine Virtua Cancer Program in Voorhees, and a thoracic surgeon at Virtua Health. “For those who need a colonoscopy – the gold standard of colorectal cancer screening – Virtua recently began offering convenient, online self-scheduling for ‘fast-track colonoscopy,’” he explained, noting that the initiative enables patients to skip the preliminary office appointment with the gastroenterologist and simply come in for the colonoscopy procedure, if a person is in generally good health and meets the medical criteria. “Thirty percent of people who qualify for colorectal cancer screening are still not getting screened, so we want to make it as easy as possible for them to get their colonoscopy.”

Revesz

Additionally, Virtua Health “has launched a system-wide initiative to identify our patients aged 40 and older who do not have a screening mammogram record on file, or who have not had a mammogram for over a year,” noted Dr. Elizabeth Revesz, a board-certified breast surgeon with the Penn Medicine Virtua Cancer Program in Voorhees. “We offer them help in scheduling a screening mammogram, if they so desire. Our goal is to reach and educate our patients, and to ultimately get them screened.”

Virtua has instituted a marketing campaign to encourage people to schedule their mammograms. It includes online scheduling, and email outreach to Virtua patients who are overdue for their mammograms, as well as patients who are at higher risk of developing breast cancer. “As a result, we’ve substantially increased the number of mammograms we provide,” Revesz said. “Public service campaigns try to convey the importance of screening, but if the ads or slogans do not resonate with people, they go unnoticed.”