eastern ontario cancer screening outreach program targeting people without family doctors
although people can self-refer to some screening programs, those without primary-care providers are often not aware or don’t know how to get screened.
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dr. anna wilkinson, a general practitioner and oncologist, and nurse-practitioner/super screener sarah junkin-hepworth are with the champlain screening outreach program.
tony caldwell
/
postmedia
on a recent evening, after finishing her day job as a family doctor and gp-oncologist at the ottawa hospital, dr. anna wilkinson headed to the giant amazon warehouse outside the city to talk to employees on their breaks about cancer screening. she and other staff from the champlain screening outreach program stayed until midnight, handing out cards with information about ontario cancer screening programs, letting workers know who qualified, why screening was important and how to make appointments.
staff from the program, including nurse-practitioner sarah junkin-hepworth, its super-screener, held similar information sessions during two other shifts at the warehouse, where 800 employees, many of them newcomers or recent immigrants, worked during each of three shifts.
they were there because a company official, worried that many employees were without family doctors and were missing routine screening, had made the request. it is just one such effort the team makes to reach out to eastern ontario residents who may be at high risk of missing screening and potentially having undiagnosed cancers. this week the program has partnered with ottawa public health’s sexual health clinic, which is holding a cervical cancer screening “pap-apalooza” event. the screening outreach team also works with community and health organizations across eastern ontario, community wellness hubs and numerous groups, including renfrew county’s virtual triage and assessment centre, a 24-hour virtual health service aimed at reducing the numbers of people waiting in emergency departments.
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amazon warehouse in the east end of ottawa.
tony caldwell
/
postmedia
wilkinson said the program would love to go to other businesses or organizations with the same need.
the made-in-ottawa solution is an innovative approach to delivering health care in an age of worsening family doctor shortages. it is part of the reality of ontario’s health system.
this week, ontario’s college of family physicians warned that up to 4.4 million ontario residents, including 318,000 in ottawa alone, could be without family doctors by 2026 if things don’t change.
cancer specialists have raised alarms that many people missed routine cancer screenings for breast, cervical, lung and colorectal cancers during the early months of the covid-19 pandemic, when people avoided hospitals. some physicians said they were seeing patients with more advanced cancers because they weren’t being caught at earlier stages.
the shortage of family physicians is making the situation worse, wilkinson and junkin-hepworth said in an interview.
although people can self-refer to some screening programs, those without primary-care providers are often not aware or don’t know how to get screened. others who are considered high risk for certain cancers were dropped from those programs when they lost their family physicians.
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“there are so many of these patients,” junkin-hepworth said.
in ontario, people can be screened for breast, colorectal, cervical and lung cancers if they qualify. the programs are aimed at catching cancers at the earliest stages possible and preventing worse outcomes and more intensive treatments.
they include: pap tests for people between the ages of 25 and 69 every three years to test for cervical cancer; mammograms to screen for breast cancer for people between 40 and 74, with people who are high risk qualifying for earlier and more frequent screening; colorectal cancer screening with stool tests every two years for people between 50 and 74, and some people at higher risk may be eligible for colonoscopies; and lung cancer screening for current and past smokers between the ages of 55 and 74.
when junkin-hepworth started working as the program’s super-screener this summer, there was a backlog of patients who were at high risk for cancers including breast and lung, but who had been dropped by the high-risk screening programs when their doctors retired. she quickly got them back into the high-risk screening system. the outreach program has now ordered 185 screening tests for people.
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its data shows that 20 per cent of people ordering screening are eligible, but have never had it previously. an additional 54 per cent are eligible, but late getting it.
although the pandemic and the family doctor shortage are key factors, wilkinson said there were also communities that tended to have lower screening rates than the general population — including recent immigrants, people in lower-income brackets and members of the black community — some of the same groups found to have lower covid-19 vaccination rates and worse outcomes.
“we see the same trends with cancer screening uptake as we did with covid,” wilkinson said.
the pilot program is the first of its kind and is attracting attention. it could be the start of something bigger, wilkinson said.
“i think we have shown with this very small project that we can increase access to screening and awareness,” she said. “i think we are going to have to be creative about how we deliver health care by thinking outside the box.”
more information can be found on the ottawa hospital’s website
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