How a community health centre boosted cancer screening for its Black and immigrant patients

Staff at the TAIBU Community Health Centre knew something needed to be done. 

Located in Scarborough, on the eastern edge of Toronto, the health clinic serves a predominantly Black and immigrant population. But looking at their patients' charts, staff found the vast majority weren't up to date with screening and the clinic was far below Ontario's provincial screening averages.

It was a concerning trend, as research shows that delays in cancer screenings often lead to later diagnosis and a higher risk of death. 

"If the community is experiencing any challenges, the answers are within the community," said Dr. Onye Nnorom, who was a family doctor at the clinic at the time. 

So back in 2013, the centre started reaching out to the community to find out why.

"One of the concerns that a number of patients mentioned was that they didn't see any data that told them how their own community was doing with regards to cancer deaths or cancer outcomes," said Nnorom. 

Other barriers were reported, too, including stigma and fear around cancer, language and cultural barriers, and a lack of education about cancer screening.

After listening to its patients, TAIBU created a task force to address patient concerns and improve its cancer screening rates for breast, colorectal and cervical cancer. 

Over a seven-year period, the clinic had surpassed provincial averages for those cancer screenings, said Nnorom, now an assistant professor at the University of Toronto's Temerty Faculty of Medicine. 

The rates for breast and colorectal cancer screenings offered tripled from 2011 to 2018, while cervical cancer screening rates also improved. (In Ontario, cancer screening rates are reported as services offered instead of completed.)

TAIBU then conducted a further audit, reviewing more than 700 patient charts for the year 2017-2018 to see if patients who were offered screening actually followed through with the tests. It found 88 per cent of mammograms, 83 per cent of fecal occult blood tests (FOBT) and 99 per cent of Pap tests were completed.

The results of the program were published this month in a study in the medical journal Canadian Family Physician.  

Between 2011-2018, the rates of breast, colorectal and cervical cancer screening offered by TAIBU increased from 17 to 72 per cent, 18 to 87 per cent and 59 to 70 per cent respectively.

The centre credits its success to using an Afrocentric approach built on listening and putting the community first.