Mass General Brigham doubles down on colorectal cancer screening

In February, Somerville, Mass.-based Mass General Brigham launched a multichannel campaign effort to boost colorectal cancer screening rates. Leveraging billboards and bus ads alongside mobile care vans and primary care networks, the system spurred more than 70% of eligible patients to complete or schedule their screening. 

Allison Bryant, MD, the system’s associate chief health equity officer, spoke with Becker’s about the screening initiative and why — for programs like these — intentionality matters.

Editor’s note: Responses have been lightly edited for clarity and length. 

Question: How did Mass General Brigham determine which communities to prioritize with this campaign?

Dr. Allison Bryant: We try to be as data-driven as possible to inform where we place our resources. The city of Boston and the state of Massachusetts have data on cancer incidence and premature mortality in various neighborhoods, cities and towns across the state. We overlapped our resources in some of those communities with where we know many of our patients live for our sites.

Secondly, what we know from our own data is that the language a patient speaks can be a big differentiator. We wanted to make sure that the [ad] campaign was accessible in multiple languages and that the website that we are driving traffic to is accessible in multiple languages.

We also translated all the standard patient-facing material into our top six languages. 

Q: Early data from the pilot program show high participation and completion rates. What do you think is driving this success? 

AB: Our north star is reducing overall deaths from colorectal cancer and then also reducing inequities in deaths from colorectal cancer. We are early in that pipeline, so that feels really aspirational at this moment, but that is why we are doing all of this work. Of the patients that we’re reaching out to, we have gotten like over 95%–90% of patients interested in enrolling in a patient navigation program. Of the patients who have enrolled, over 70% have now completed testing. 

The patients that we approach for this are folks who come from some of our community health centers and who we know have a higher burden of social needs than others. Colorectal cancer screening isn’t the easiest thing to do. Even if you are well-resourced and have high health literacy, it’s challenging. There are lots of people who have competing demands or other barriers to getting there. A provision of a little extra support, a patient navigator that helps get you from point A to point B, point B to point C, is really quite appealing to some of our patients and probably accounts for both the high uptake of enrollment and getting patients all the way to the finish line.

Q: Looking ahead, how do you plan to scale or evolve the campaign?

AB: Right now, there are patient navigators at a few of our primary care sites. We will be scaling up to a few more of the primary care practices and then, super importantly, to our community care vans.

We’ve picked colorectal cancer because there’s already ongoing work and a pathway for how to get people to the right evidence-based screenings. Our hope is to design this for colorectal cancer and then use these learnings to think about all the other cancers that too many people are dying from too soon. Why not lung cancer? Why not prostate cancer? Why not breast cancer?

Q: What advice would you give to other hospital and health system leaders who are considering similar cancer screening initiatives?

AB: Be aspirational. We have a leadership that is pushing us to be bold and broad. We want to aim big.

In the long game, understanding your own data is key. What does your geography look like? What does your patient population look like? What are the challenges? I’d imagine that there’s no healthcare organization around for whom premature death from cancer is not a problem.

As you think about quality strategy, be thoughtful about planning for equity at the same time. Design your program for the patient who has low health literacy or doesn’t speak English from the beginning.

And then really, just meeting people where they are. Where are your patients? What community-based organizations can you partner with to meet patients and your communities where they are?