EDC Releases Cancer Screening Curriculum

• Every 12 minutes, a woman in this country dies of breast cancer.
• Roughly every two hours, a woman dies of cervical cancer.
• Women from all cultural and economic groups develop breast and cervical cancer, but
• Survival rates for these cancers are directly related to socioeconomic status.
• Poor women are diagnosed later, receive less care, and die sooner.

While mammography and pap smears have demonstrated great success in identifying cancer in earlier, more treatable stages, these effective screening tools remain underused today. Too many women still die from breast and cervical cancer that could have been treated early as a result of timely detection.

To help physicians, physicians assistants, nurses, and nurse practitioners develop the skills they need to encourage women to be screened for breast and cervical cancer and to educate patients about risk factors, EDC and Dartmouth Medical School have developed a continuing education curriculum for health care professionals. Funded by the Centers for Disease Control and Prevention, Building Partnerships for Breast and Cervical Cancer Risk Management addresses many of the barriers that keep women, particularly poor and minority women, from preventive care.

Barriers to effective prevention range from infrequent office visits and financial constraints to anxiety and cultural preconceptions about disease. For instance, “in many cultures, values with respect to modesty and sexuality, especially for unmarried women, may partly account for a lack of attention to breast health,” explains Melanie Adler, a researcher on the project. In other communities the fear of pain or radiation may prevent women from getting the screenings they need. In addition, financial insecurity, lack of health insurance, and fragmented medical services can all contribute to a woman’s reluctance to pursue preventive care.

The recommendation of a doctor or nurse is often the most powerful factor in overcoming patient reluctance. But primary care providers themselves are too often ineffective advocates for these important procedures. Tight office schedules, concerns about the cost of mammography for poor patients, and misinformation about risk factors can prevent a doctor from recommending screening procedures when they are appropriate. In addition, Adler explains, “doctors who only see patients for acute conditions may be more likely to feel the press of time and to put off conversations about the importance of breast and cervical cancer screenings.”

Building Partnerships addresses many of these challenges by combining current clinical information and screening guidelines with strategies for effective interviewing and counseling procedures. The curriculum takes a case-based approach to building the communication skills of health care providers. With print, slide, and video material, it models effective patient-provider interactions designed to help primary care providers gather relevant data, offer appropriate support and response to their patients’ concerns, and educate patients about cancer risks and screening issues. The curriculum is modular and designed to fit into ongoing teaching and continuing education programs at hospitals and clinics. It can be used in both small and large group settings.