Sharing What We Have Learned: Healthy City Collaborative

Sharing What We Have Learned is sponsored by the Office of Community Engagement and Neighborhood Health Partnerships, Healthy City Collaborative, and the Office of Health Literacy, Prevention, and Engagement. We are pleased to highlight research and community engagement activities of UIC researchers. Each month we feature a researcher and important findings from their work. This information is shared in a ready-to-use format suitable for widespread distribution. If you would like more information about our efforts to share what we have learned, visit our website or email sabrina1@uic.edu.

Keith Naylor, MD, Assistant Professor of Medicine
Division of Gastroenterology and Hepatology
Director, Gastrointestinal Cancer Prevention Program
Co-Chair, Illinois Cancer partnership Screening and Early Detection Subcommittee
Co-Lead, Chicago Cancer Health Equity Collaborative Outreach Core

“Examining colorectal, breast, and prostate cancer screening and diagnosis among Chicago Community Health Center patients during the COVID-19 pandemic”

Introduction
Cancer is the second leading cause of death in the United States, causing over 600,000 deaths each year. However, many of the most common cancers are highly treatable, or in some cases preventable, with appropriate cancer screening and early detection. Cancer screening can be described as tests that are intended to detect or diagnose cancers in individuals who have no signs or symptoms of cancer. Many cancer screening tests are recommended for healthy men and women as a part of their routine preventative health care, based on age, sex at birth, family history of cancer, as well as other risk factors.

Over the past 20 years, the cancer death rate has decreased by over 25% in large part due to increased cancer screening and advances in treatment. Unfortunately, the COVID-19 pandemic caused major disruptions in multiple aspects of health care, including cancer screening, diagnosis and treatment. Nationwide, at the onset of the pandemic, there was an estimated 90% decrease in breast cancer screening, 79% decrease in colon cancer screening, and a 63% decrease in prostate cancer screening. Presently, it is not known how these declines impacted racial/ethnic minority populations, or how they may affect cancer diagnosis and survivorship.

Throughout the COVID-19 pandemic, safety-net health systems, including public hospitals, have served a crucial role in providing health care to the uninsured and individuals with Medicaid insurance. As a vital component of the safety-net health system, Community Health Centers provide comprehensive primary health care services to many communities of color and the medically underserved. In Chicago, the COVID-19 pandemic and resulting lockdown caused severe disruptions in health care delivery, including hospitals canceling many elective procedures, such as cancer screening exams, and CHCs limiting in-person visits where cancer screenings often occur.

Chicagoans living in medically underserved community areas, who rely on CHCs for cancer-related screening and other care, may be particularly vulnerable to these disruptions due to the complex interaction of individual, social, and health-system-level factors that are known to contribute to cancer-related health disparities. To achieve health equity and eliminate cancer-related disparities, it is essential to understand which individuals and community areas were impacted most by the pandemic-related effects on cancer screening and diagnosis.

Through research supported by the University of Illinois Cancer Center Community Outreach and Engagement Office, and in collaboration with the Chicago Cancer Health Equity Collaborative, we are examining the impact of COVID-19 on cancer screening rates and subsequent care among patients seen at Alliance Chicago affiliate Community Health Centers.

To accomplish this, we are reviewing cancer screening-related information obtained from the Chicago Area Patient-Centered Outcomes Research Network (CAPriCORN). CAPriCORN-affiliated health care organizations include: 392 primary care clinics and 32 hospitals that serve over 12 million patients across Cook County. From this wealth of information, we hope to learn more regarding how cancer screening and diagnosis at Chicago’s CHCs changed over the pandemic.

About Our Researcher
Dr. Naylor is an assistant professor of clinical medicine and a practicing gastroenterologist at the University of Illinois Chicago and co-lead of the Chicago Cancer Health Equity Collaborative Outreach Core. His clinical focus in the diagnosis and management of hereditary and familial gastrointestinal cancer syndromes, as well as colorectal cancer screening and prevention. Dr. Naylor directs the Gastrointestinal Cancer Prevention Program at the University of Illinois Health Center, and he is the acting co-chair of the Illinois Cancer Partnership’s Screening and Early Detection subcommittee. Dr. Naylor’s research centers on using administrative health data to investigate variation in the utilization and quality of cancer related health care, with specific focus on increasing the utilization of care among social racial and ethnic minority patient populations.