Louisiana leads the nation in cancer mortality—and not in the good sense. The state’s cancer mortality rate is 14% higher than the national average. Much of the problem lies in late diagnosis. Louisiana residents are less likely than other Americans to undergo recommended screenings, so their tumors tend to be more advanced upon detection.
The Mary Bird Perkins Our Lady of the Lake Cancer Center in Baton Rouge has been working to change that by bringing free screening services directly to people where they live and work. The cancer center began in 2002 by driving its mobile clinic to communities where many residents are uninsured or underinsured. Now, it is supplementing that successful program with a new pilot that brings free screenings someplace even more unexpected: to local workplaces that insure many employees.
Sandra Holub, executive director of the Albemarle Foundation, a local philanthropy organization funding the new effort, believes the mobile clinic can help to increase early detection in populations that don’t get regular screening. “I have great insurance. I know exactly what I should be doing, yet I’ve never taken the time to get a skin screening, and I’m not alone. Research indicates that most fully insured people fail to follow American Cancer Society screening guidelines, and that’s why this is such an important program,” she said.
Officials hypothesized that Louisiana’s high cancer mortality rates would mean that the state had equally high incidence rates. The general lifestyle of the state’s population supported that assumption. Louisiana’s residents are more likely than Americans, as a whole, to smoke tobacco, drink alcohol, and put on weight. They also spend an unusual amount of time outside, under an intense southern sun. It turned out, however, that Louisiana’s cancer incidence rates are about average and that researchers needed to look elsewhere to explain what’s causing the high mortality rates (Table
Researchers at the Louisiana Tumor Registry placed much of the blame on the state’s unusually low screening rates. Officials at the Baton Rouge cancer center responded to those findings by looking for ways to boost screening in communities where it was lowest: poor communities that housed many of the 23% of all state residents who, at the time, lacked insurance. In 2002, the cancer center’s mobile screening center rolled out of the driveway for the first time.
Since then, the healthcare workers who staff the mobile clinic have set up shop in the parking lots of churches, shopping centers, government offices, barbershops, and any other place that might attract new patients. They have screened more than 74,000 people, so far, and detected more than 500 cancers.
“The program has been more effective than we dared to hope when we launched it, not only because we’ve educated and screened so many people who would not have otherwise had access to these services, but also because we have detected so many cancers. Our detection rate is roughly twice what you’d expect from a truly random patient population, so clearly we are serving a population that really needs to be served,” said cancer center President and CEO Todd Stevens.
It turned out, however, that uninsured people weren’t the only ones who needed service. Fully insured people showed up at the mobile screening center almost from the start and grew into a significant percentage of all the patients who visit.
“These insured individuals told us they didn’t have time to miss work and make a special trip for screening, but they decided to come when they saw our mobile clinic someplace they already visit for other reasons,” Stevens said. “Eventually, we started exploring ideas to bring information about cancer, cancer prevention, and access to primary screening into the workplace.”
Cancer center officials investigated the concept from many angles. They looked at the research and found that significant percentages of full-time workers skip recommended screenings. They surveyed employees at local companies and heard that many workers who missed screenings would consider taking advantage of a cancer-related program in the workplace. Then, they went in search of donors to fund it.
They soon came to the Albemarle Foundation, a local philanthropy that’s largely funded by the specialty chemical company Albemarle Corp and its thousands of employees. Both the foundation and the corporation have longstanding ties to the Baton Rouge center, and they soon became intrigued by the idea of workplace cancer screenings.