BACKGROUND: Three current and former awardees of the Centers for Disease Control and Prevention's Colorectal Cancer Control Program launched integrated cancer screening strategies to better coordinate multiple cancer screenings (e.g., breast, cervical, colorectal). By integrating the strategies, efficiencies of administration and provision of screenings can be increased and costs can be reduced. This paper shares findings from these strategies and describes their effects. METHODS: The Idaho Department of Health and Welfare developed a Baseline Assessment Checklist for six health systems to assess the current state of policies regarding cancer screening. We analyzed the checklist and reported the percentage of checklist components completed. In Rhode Island, we collaborated with a nurse-patient navigator, who promoted cancer screening, to collect details on patient navigation activities and program costs. We then described the program and reported total costs and cost per activity. In Nebraska, we described the experience of the state in administering an integrated contracts payment model across colorectal, breast, and cervical cancer screening and reported cost per person screened. Across all awardees, we interviewed key stakeholders. RESULTS: In Idaho, results from the checklist offered guidance on areas for enhancement before integrated cancer screening strategies, but identified challenges, including lack of capacity, limited staff availability, and staff turnover. In Rhode Island, 76.1% of 1023 patient navigation activities were for colorectal cancer screening only, with a much smaller proportion devoted to breast and cervical cancer screening. Although the patient navigator found the discussions around multiple cancer screening efficient, patients were not always willing to discuss all cancer screenings. Nebraska changed its payment system from fee-for-service to fixed cost subawards with its local health departments, which integrated cancer screening funding. Screening uptake improved for breast and cervical cancer but was mixed for colorectal cancer screening. CONCLUSIONS: The results from the case studies show that there are barriers and facilitators to integrating approaches to increasing cancer screening among primary care facilities. However, more research could further elucidate the viability and practicality of integrated cancer screening programs.

BACKGROUND: The objective of this study was to evaluate an ongoing initiative to improve colorectal cancer (CRC) screening uptake in the New York State (NYS) Medicaid managed care population. METHODS: Patients aged 50 to 75 years who were not up to date with CRC screening and resided in 2 NYS regions were randomly assigned to 1 of 3 cohorts: no mailed reminder, mailed reminder, and mailed reminder + incentive (in the form of a $25 cash card). Screening prevalence and the costs of the intervention were summarized. RESULTS: In total, 7123 individuals in the Adirondack Region and 10,943 in the Central Region (including the Syracuse metropolitan area) were included. Screening prevalence in the Adirondack Region was 7.2% in the mailed reminder + incentive cohort, 7.0% in the mailed reminder cohort, and 5.8% in the no mailed reminder cohort. In the Central Region, screening prevalence was 7.2% in the mailed reminder cohort, 6.9% in the mailed reminder + incentive cohort, and 6.5% in the no mailed reminder cohort. The cost of implementing interventions in the Central Region was approximately 53% lower than in the Adirondack Region. CONCLUSIONS: Screening uptake was low and did not differ significantly across the 2 regions or within the 3 cohorts. The incentive payment and mailed reminder did not appear to be effective in increasing CRC screening. The total cost of implementation was lower in the Central Region because of efficiencies generated from lessons learned during the first round of implementation in the Adirondack Region. More varied multicomponent interventions may be required to facilitate the completion of CRC screening among Medicaid beneficiaries. Cancer 2018;124:000-000.

Since the inception of the Centers for Disease Control and Prevention (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in 1990, partnerships have played a significant role in providing breast and cervical cancer screening and early detection to uninsured and underinsured women. The state, tribal, and territorial NBCCEDP grantees have shared resources and responsibilities with a variety of partners (eg, community-based organizations, government agencies, tribes, health care systems, companies, professional organizations) to achieve common goals. National partners, such as the American Cancer Society, Susan G. Komen for the Cure, and the Avon Foundation for Women, have provided funding, lobbied for national and state funding, supported outreach and education activities, and provided treatment referral services for the programs. This article provides an overview of grantee partnerships to illustrate the effects, successes, and challenges of these partnerships and how they have affected the populations served by the program.

BACKGROUND: Since 2003, newer cervical cancer screening guidelines that include human papillomavirus (HPV) testing with cytology (HPV co-testing) call for extension of screening intervals in women who are cytology normal and HPV negative. Continuing medical education (CME) may help increase knowledge and appropriate adoption of new technologies and guidelines. However, there are concerns that industry support of CME may bias messages favoring newer technologies without emphasizing the updated guidelines, especially less frequent testing recommendations. Our objectives were to assess availability and accuracy of web-based CME activities describing cervical cancer screening guidelines, screening intervals, and HPV testing. METHODS: We identified 20 web-based CME activities available between 2006 and 2008 and evaluated the content for messages related to HPV and natural history, cervical cancer screening guidelines, management of HPV abnormalities, and counseling tips for patients. In addition to content, we noted funding source, credit offered, and dates available. RESULTS: Most activities (80%) discussed the updated screening guidelines with HPV co-testing for eligible women. Twelve activities (60%) referenced professional organization support of the extended screening interval with the HPV co-test, and three (15%) discussed the justification for extension of intervals for eligible women. Eight activities (40%) were funded by industry, seven of which included accurate, updated screening guidelines about extension of screening intervals. CONCLUSIONS: Web-based CME activities generally support updated guidance for HPV co-testing and extended screening intervals but need more information on counseling patients and acceptability of extending screening intervals.