Don Sabol, 63, of Kampsville, Illinois, is—literally—a poster boy for cancer screening. After receiving a flier from Siteman Cancer Center about the importance of early detection, Don asked his doctor about screening for lung cancer and discovered he qualified because of his history as a smoker. He was shocked and scared when he was subsequently diagnosed with early-stage lung cancer, but early detection helped save his life.

Don is now sharing his story because he wants to help people learn about the value of screening and early detection. He and others who chose to be screened are now participating as spokespeople—in advertisements and posters, for example—for the Get Screened Now program initiated by the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine. The program is intended to increase public awareness about the importance of screening, with an emphasis on those who are medically underserved. The outreach initiative is promoting the value of several types of cancer screening, including breast, prostate, colon and lung. (For more information about qualifying for lung cancer screening, visit: siteman.wustl.edu/lungcancer.)

Get Screened Now offers important information about the benefits of screening and offers help in finding convenient screening locations.

The related website—getscreenednow.com—includes information about risk factors for cancer and the types of screening tests available, and it allows visitors to search for screening locations by ZIP code.

Response to an urgent need

 “In 2020, we recognized that there was a 50% reduction nationally in the diagnosis of cancer,” says Siteman Director Timothy Eberlein, MD, senior associate dean for Cancer Programs at Washington University School of Medicine and BJC HealthCare. “That doesn’t mean that 50% fewer people had cancer. It means 50% fewer people were getting the mammograms, colonoscopies and PSA (prostate specific antigen) tests that can detect cancer. So what were the consequences of that decrease in 2021? Talk to any of our surgeons today, and they will tell you that they are still treating the consequences.”

That 50% reduction in cancer screening resulted in an increase in late-stage diagnosis. Generally speaking, the later the stage of cancer, the more difficult it is to successfully treat. For some people, a cancer diagnosis comes so late in the progression of the disease that surgery and other standard treatments cannot adequately address it. The result is a more dire prognosis, even for certain types of cancer that generally are considered highly treatable when diagnosed early.

In response to this alarming situation, Eberlein and other Siteman colleagues decided to undertake a major effort to spread the word about the benefits of cancer screening. The campaign, developed over the past year, is intended to reach beyond the 82 counties in eastern Missouri and southern Illinois that typically are part of Siteman’s outreach efforts. To help expand the initiative’s reach, Siteman is partnering with affiliate hospitals, health clinics and providers, many of them located in rural communities. “We are working to double-down on screening,” Eberlein says. “Our goal is to get more people screened. And if the screening results in a cancer diagnosis, our hope is that we will identify it at an earlier, more treatable stage.”

Cancers of the breast, colon, prostate and lung account for half of all cancers diagnosed in the United States, and they are the focus of the outreach program. Screening tests that detect early abnormalities are readily available for each of these, and some, including colonoscopy, can detect precancerous conditions. “If a person is diagnosed with cancer after screening, we’ll help ensure they follow up with further tests and treatment,” says Graham Colditz, MD, DrPH, associate director of prevention and control at Siteman Cancer Center.

Coordinating the message

Get Screened Now is a collaborative effort that includes advertising, public service announcements by area celebrities, including former St. Louis Cardinals baseball player Yadier Molina, and hundreds of health-care providers. The urgency of the situation—and the potential to save lives—is at the heart of the campaign.

“We’re also employing some of the tools we’ve developed in the past to help educate and inform,” Eberlein says. Colditz helped develop some of those tools, including a checklist titled “8 Ways to Stay Healthy and Prevent Cancer” and an assessment tool called “Your Disease Risk.” (For more information about these see the sidebar at the end of this story.)

Many of the people who respond to Get Screened Now messages and undergo screening will have no evidence of the disease. But the program doesn’t stop there. It also offers information about ways to decrease the risk of cancer in the future, and it identifies those who may need follow-up screening. The initiative also will help people locate local programs that can help reduce the risk of cancer, including exercise, nutrition and smoking cessation programs. “We’ve designed a comprehensive resource that starts with screening and also includes ways to improve the health of the people we serve,” Eberlein says.

Reaching the underserved

While the value of cancer screening and early detection is virtually the same for everyone, there are significant differences in the ways people can—and can’t—access medical care, including screening. People living in urban areas, those who have easy access to transportation, those with flexibility in their work schedules: These individuals are more likely to undergo screening exams. People with fewer resources and flexibility are not.

“We want to reach people who often don’t have easy or reliable access to health care and those who are uninsured or underinsured. We want to remove the barriers to getting screened,” Colditz says. For example, Siteman’s mobile mammography van will visit areas where rates of screening for breast cancer are low. And community organizations and churches are collaborating with health-care providers to help raise awareness in targeted neighborhoods and communities.

Every Get Screened Now message includes a website and a phone number for information about local health care providers and screening centers. Katie Hoey, Siteman’s program manager for external partnerships, worked with health systems, hospitals, federally qualified health clinics and community health centers to ensure that the list of resources is comprehensive. She estimates that the current list includes nearly 400 screening centers. “We’re continually updating the list of screening locations to make sure it’s as complete and accurate as possible,” she says.

Adapting for success

Both Colditz and Eberlein point out that the southern portions of Illinois and Missouri, part of the Mississippi Delta region, have the nation’s highest rates of colon cancer. This geographic area also has lower rates for colon cancer screening compared to greater St. Louis and other more populated areas, although Eberlein says several factors contribute to the high rate of colon cancer. Smoking and obesity, for example, are more common in those areas, and residents tend not to participate in nutritional and exercise programs. This region, Colditz notes, is an example of an area that has been historically under-resourced in terms of standard cancer-prevention services.

Because the Get Screened Now program has been designed to monitor and adapt its message for maximum success, “we’ll work to ensure that the way this program serves each specific area is appropriate to the needs of the people living there,” Colditz says. Eberlein notes that one of Siteman Cancer Center’s partners in southern Illinois is located in this part of the Mississippi Delta area. “And Siteman’s satellite location in south St. Louis County is not that far away. We have the resources to provide screening and educational tools that can help improve the health of those living in that area.”

“We’re working to better meet people where they are,” Colditz adds. Get Screened Now is designed to reach as many people as possible with an important message: Cancer screening saves lives.

The overarching goal is to provide a screening opportunity for every person who encounters a message from the Get Screened Now program, Hoey says. “There are options for those who are uninsured or underinsured. We want to encourage people to have a conversation with a doctor about screening and help them find the locations where they’re eligible for those screenings.”

An ongoing effort

As is true with other Siteman Cancer Center wellness and prevention programs, Get Screened Now is expected to continue as a significant, effective and collaborative effort. Eberlein hopes the program will become a model for smaller, regional health-care systems and providers not affiliated with Siteman Cancer Center, thus broadening the scope of awareness and resulting in healthier communities. “This is a massive, all-hands-on-deck kind of program, and it represents an ongoing commitment by Siteman and other health-care providers in the region,” Eberlein says. “We can demonstrate that routine screening will reduce the risk of mortality because it helps us find cancer when it’s more easily treatable. And that’s the outcome everyone wants.”

Resources

Read “8 Ways to Stay Healthy and Prevent Cancer”
Take the cancer assessment “Your Disease Risk”
Learn more about screening and availability near you

Cancer Screening Basics

Guidelines can vary, so talk with your health-care provider about screening at these ages*:

Age 21

• Cervical cancer

Age 40

• Breast cancer
• Prostate cancer: for African American men and others at higher risk, discuss benefits and risks of screening

Age 45

• Colon cancer
• Prostate cancer: for average-risk men, discuss benefits and risks of screening

Age 50

• Lung cancer: for people who soke or used to soke

*If you have a family history of cancer, you may need screening at a younger age.