The Impact of a Student-Led Initiative to Improve Cancer Screenings in Primary Care.

Abstract

System-level interventions are needed to improve early breast cancer detection and prevent colon and cervical cancers owing to suboptimal adherence to screening guidelines in the U.S. A student-led outreach initiative was conducted at a New Jersey family medicine practice to improve screening rates among overdue patients. From January 1, 2023 to February 1, 2025, an interventional cohort study identified 911 patients aged 21-80 years through electronic health record review, of whom 822 were confirmed to be overdue and eligible for outreach. The primary outcome was completion of guideline-recommended screenings within 2 years. Thirty-three students contacted 822 patients who were overdue for cancer screening (mean age of 61 years; 74% female; 63% White, 16% Black, 3% Hispanic, 3% Asian), representing 1,365 overdue tests. Successful contact was made with 386 patients (47%), of whom 53 (13.7%) reported being up to date, verified when possible. The screening status of the 436 uncontacted patients was unknown, so all 822 were retained in the denominator to avoid overestimating intervention effects. Outreach generated an 11.4% referral rate (156 of 1,365), including 47 colonoscopies, 39 Cologuard, 48 mammograms, and 22 Pap smears. Completion rates were 5.5% for colon cancer (35 of 636), 6.7% for breast cancer (27 of 402), and 3.1% for cervical cancer (10 of 327). Abnormal findings occurred in 57.9% of colonoscopies, 18.7% of Cologuard tests, 33.3% of mammograms, and 0% of Pap smears. This student-led outreach to patients overdue for cancer screenings facilitated referrals for colorectal, breast, and cervical cancer; supported early detection of abnormalities; and provided students with hands-on experience in preventive medicine, fostering development as community-focused physicians.