Health promotion campaigns have long stressed the importance of tailoring messaging so that it is specific to local needs. Those living in rural settings are among the most challenging populations to target in these efforts due to their isolation from health promotion services. In a recent publication in the Journal of the American Medical Association (JAMA), author Victoria Champion and colleagues considered different mediums for breast, cervical, and colorectal cancer screening campaigns in rural locales in the US. A comparison of the mediums showed that the use of a video on the subject accompanied by communication with a patient navigator encouraged a greater rate of screening in the target population. GlobalData epidemiologists forecast an increase in cervical, breast, and colorectal cancer in the US, underscoring the need for cancer prevention promotion, especially among rural residents and other underserved populations. A growing effort to engage with rural parts of the US through tailored cancer prevention initiatives such as those proposed by Champion and colleagues may increase the incidence cases of cancer through early detection while reducing advanced cases and deaths.
Between 2016 and 2019, Champion and colleagues recruited 983 women aged between 50 and 74 years from rural counties in Ohio and Indiana for the clinical trial. All participants were not up to date in screening for breast, cervical, or colorectal cancer, according to US Preventive Services Task Force standards. While one group was exposed exclusively to an informational DVD, the latter cohort received the DVD followed by an average of three calls from patient navigators, who discussed the DVD’s contents and provided counselling on doubts or barriers regarding cancer screening. Following a 12-month period after the intervention, participants self-reported if they had sought out cancer screening. An analysis showed that those who received the DVD were twice as likely to seek screening for all three cancers compared to the control group, while those with the added patient navigator interaction were six times more likely. Furthermore, the use of a DVD and patient navigator was more cost-effective at $10,638 per up-to-date patient compared to $14,462 for the DVD-only intervention.
In the face of an urban-rural divide in healthcare equity, Champion and colleagues offer one potential solution for targeting rural populations in health promotion interventions. The use of a video medium accompanied by personalised, direct interaction with a health professional allows for a cost-effective method of boosting cancer screening that leverages remote communication methods with promising results. GlobalData forecasts that diagnosed incident cases of cervical cancer in the US will increase from over 13,300 cases to almost 14,400 cases between 2020 and 2030. Similarly, diagnosed incident cases of colorectal cancer are expected to grow from more than 141,900 cases in 2021 to nearly 161,500 cases in 2031, and invasive breast cancer cases will grow from approximately 256,139 cases to almost 297,800 cases between 2018 and 2028. If interventions such as the one executed by Champion and colleagues can encourage higher screening uptake among rural Americans, incident cases of these cancers may increase due to early detection, but the number of advanced-stage cancers and deaths may simultaneously decrease due to patients receiving more timely treatment. While delivering health interventions for rural patients poses a unique set of challenges, campaigns such as that suggested by Champion and colleagues may offer a framework for a more equitable cancer prevention strategy in historically underserved regions of the country.