Eliminating Barriers to Cancer Screening through Use of Navigator Medical Assistants

About This Grant:

In late 2012 – before Penobscot Community Health Care (PCHC) began implementing outreach strategies using a medical assistant (MA) – cancer screening rates for PCHC were lower than both the U.S. or Maine averages. The pilot MA outreach project proved successful, with compliance increases of 6% to 21% across mammography, Pap, and colonoscopy/FIT screenings.

The work plan for the Gaps-in-Care Outreach MA, generously funded by Maine Cancer Foundation in 2014, built on that previous success. Thus far, we have seen a greater than 50% return rate for FIT tests with an overall colorectal cancer screening rate of 57%, mammography 59%, and Pap 58%. In order to continue this positive trend toward appropriately timed screenings for breast, cervical, and colorectal cancers, PCHC and St. Joseph Healthcare (SJH) are requesting $164,000 over the three-year grant period to hire two new, system-wide Navigator MAs (one for each organization). The shared goals are 75% compliance for mammograms, 75% compliance for Pap smears, and 65% compliance for colorectal cancer screenings.

Because the rate of screening among PCHC patients is lower than the Healthy People 2020 screening goals of 70% for colorectal cancer, 80.1% for breast cancer, and 93% for cervical cancer, the entire adult PCHC patient population, as well as their family members, will benefit from early detection and commensurate increase in successful cancer treatment and survival.

From October 2012 to July 2014, with support from an American Cancer Society grant, a medical assistant from PCHC was charged with contacting patients for this purpose, which increased the number of individuals obtaining age- and gender-appropriate screenings. With this outreach, PCHC documented a slight up-tick in breast cancer screening; cervical and colorectal stayed about the same.

Through this renewed effort, and with greater emphasis on cervical and colorectal interventions, PCHC hopes to come closer to Maine’s impressive rates for “screenings at recommended intervals.” In the case of mammograms, we anticipate exceeding that rate (75% vs. 65%). So far PCHC is seeing colorectal cancer screening at 57%, mammography at 59%, and cervical cancer screening at 58%. St. Joseph Healthcare primarily will focus on improving the 2014 cervical screening rate of 58.6% to move it closer to the shared goal of 75% and the Healthy People 2020 goal of 93%. While SJH current screening rates of colorectal 71% and mammography 82% are in line with Healthy People 2020 goals, these rates need to be maintained and improved. The ultimate goal of both organizations is 100% screening for optimum early detection.

Breast Cancer
Colorectal Cancer
Patient Navigation
Patient Support


Year Grant Title Category Amount Grant Recipient
2018 Improving Colorectal Screening Rates via Use of a Medical Support Assistant Colorectal Cancer, Screening $100,000 Penobscot Community Health Care
2018 Improving Patient Outcomes via Dermatology eConsult Prevention $12,174 Penobscot Community Health Care
2017 Expanding Systems to Increase Colorectal Cancer Screening through Patient Outreach and Recall Colorectal Cancer, Screening $100,000 Penobscot Community Health Care
2017 Peer-Led Tobacco Cessation Training at Unlimited Solutions Clubhouse Prevention, Tobacco $26,116 Penobscot Community Health Care
2016 Provide a Reminder and Recall System for Colorectal Cancer Screening Colorectal Cancer, Screening $30,000 Penobscot Community Health Care
2015 Eliminating Barriers to Cancer Screening through Use of Navigator Medical Assistants Breast Cancer, Colorectal Cancer, Patient Navigation, Patient Support, Screening $164,000 Penobscot Community Health Care