Lyn Robertson, DrPH, MSN, BSN, Associate Director for Health Equity and Community Outreach and Engagement, UPMC Hillman Cancer Center discusses efforts underway to connect uninsured and underinsured people with free cancer screenings.
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– This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgments when advising their patients. Patients in need of medical care should consult their personal care provider.
– Connecting people in the community to important health screenings. Welcome to the UPMC HealthBeat podcast. I’m Tonia Caruso, and joining us right now is Dr. Lyn Robertson. She is the associate director for Health Equity and Community Outreach and Engagement with UPMC Hillman Cancer Center. Doctor, thanks so much for joining us.
– You’re welcome. I’m glad to be here.
– So let’s begin by telling me what the goal of this work really is.
– The goal of prevention and early detection and actually being out in the community is to reach those individuals who otherwise either hesitate or don’t get screened for the recommended cancer screenings. We do it through education and also facilitating actual screenings. I’m actually, and my team, are in communities throughout the 29-county catchment area of UPMC Hillman Cancer Center, and we work with the various facilities, UPMC facilities, in those counties, and we also work with various agencies, institutions, etc., that are within those counties and like to work with us in regards to education and screening of populations out there.
– And let’s talk in general about the importance of screening, and what do we know about screening as it relates to outcomes?
– Screening is very important because the earlier we can detect cancer, the better chance we have of treating it, putting the person into remission, and having them go on to live a quality of life or their normal lifespan. So it’s very, very important with cancer that you detect it early.
– And so, talk to me more about the program and just how exactly it works. Who do you connect with in the community, and are there certain groups you find need more conversation about this?
– It’s a great question. I connect with communities, and I think that connect is very, very important because in connecting with communities, we don’t go out there and tell the community what they need. We go out there and sort of learn about the community, work with key leaders in the community, which may be some of our local politicians, it may be school districts, it may be senior high-rises or senior community centers, it may be the Y, it may be libraries. It may be “Johnny on the street” who happens to have heard a lecture that I gave somewhere or one of my team did and they want to know more, and they want us to reach other groups like the PTA or Grandmothers for Pearls, or some organizations that are out there that may volunteer in communities, but also have people that they know need to learn about their health, need to learn about what screenings they need to be doing, and also to get them done.
– And so, doctor, can you give us a sense of what are the types of screenings that you help connect the community to?
– Certainly. I’d be happy to. We connect the community with breast cancer screening, cervical cancer screening, skin cancer screening, colorectal cancer screening, low-dose CT screening for those that are eligible for early lung cancer detection, and also prostate cancer screening if the individual’s at high risk.
– Can you talk briefly about how this takes place? How do you connect them to these programs?
– We connect them to these programs by, first of all, talking to the individual on a one-to-one, determining their age and their risk and whether or not they’ve been screened before, and then from there, we ask them if they’d like to be screened, and if they indeed say they do, then what we do is work with setting up an appointment. It depends upon the type of screening. If it’s a breast cancer screening, then we would, in most instances because I work with uninsured or underinsured individuals, I would obtain a mammography voucher, schedule their mammogram, and then talk to them about any barriers or anything that may stand in the way of them getting to their appointment. Maybe they don’t have transportation and they need assistance with that. Other types of screening we can do, sometimes, right on site, if the facility where I’m at has en exam room. Or, we also have a Prevention and Early Detection suite in the ground level of the Hillman Cancer Center, and we can actually make the appointment there with one of our nurse practitioners.
– And beyond the idea of someone being uninsured or underinsured, are there other reasons people tell you that they don’t want to be screened?
– Yes. Some of it’s fear, fear of the unknown — they’re afraid that something might be found. Sometimes it’s myths, or stories that they’ve heard, or experiences they’ve had. “I had Great Aunt Sally, and she was diagnosed with breast cancer and never got out of bed again and died.” Or, “I’ve heard that if you go and you get a mammogram, that’s a lot of radiation, and I don’t want to be exposed to that radiation.” So there are a lot of myths out there in the community, so sometimes it takes more time than you can imagine to actually work with an individual and get them in to be screened. Many of the individuals that are out there in the community don’t have medical homes. So that’s something else we really try to do. We try to plug them into what we call, we call them medical homes, but it’s actually a medical provider. And it may be a free clinic, a federally qualified health clinic, or we may help them to get coverage so that they can choose the provider of their choice. However, that’s easier said than done in many instances because individuals that don’t get screened usually aren’t screened or don’t have health care providers for reasons. And a lot of those barriers, we have to work with them on so that we can get them plugged into medical systems.
– But you’re always willing to take on new partners, as well?
– Always. And individuals can call on their own. They can just call our main number and say, “I think I need a mammogram,” “I’m not sure I need a mammogram,” or, “Maybe I need a gyno exam or a colorectal cancer screening.” The main number to call is 412-647-1809. We will get back to them and assess their risk over the telephone and then get them set up for whatever’s needed. And I think what people need to realize that despite what’s going on with the pandemic, screening is very, very safe here at UPMC. We take all precautions that are necessary, and individuals can feel very comfortable coming in and having whatever screening they need done.
– A lot of this is community outreach. Is this still, are you still able to do this in the time of COVID?
– We are because we’ve been out there for a number of years. I know myself, I think I really worked to develop the program about 10 years ago or better. And so, being out there that long, we’ve made enough community-based connections that once the initial fear of the pandemic sort of settled down, I reached out to all of our collaborators, and we developed virtual ways to stay in contact, and many of the clinics, the free clinics or the federally qualified health clinics, and even some doctors that are out there and run into patients that are uninsured or underinsured, just either pick up the phone and call, or they send me an email and say, “These people need this, this, and this,” and we facilitate it.
– Any idea of how many people you have helped and how many people who have gone through screenings thanks to your program?
– Thousands. I could honestly tell you on an average year, we have one-to-one interaction with somewhere between 5,000 and 7,000 individuals. Over the years, I mean, on any given year, I’m just trying to reflect back, we probably do between 250 to 300 free mammograms. That’s not including colorectal screenings, the low-dose CT, the prostate screenings that we may do, or the cervical cancer screenings.
– You are so passionate about this work, and tell me why that is.
– I’m passionate about this work, and really, it’s because I really strongly believe that the only way we’re going to conquer this disease is by early detection and prevention, as well as our research. It’s important that we meet people where they are, that we’re in the community and we talk to them, learn about them, and realize that what I may know, they may not know. So by educating them and sometimes guiding them and helping to direct them, then they too can get the kind of services they need, and hopefully, be diagnosed early, or hopefully, get a clean bill of health and not get diagnosed at all. I generally tell people because I hear it a lot: “I’m very afraid to get screened because what if there’s something there?” And I say to them, you’re letting fear stand in the way, and we all are afraid when it comes to being screened. But in reality, if you get screened and everything’s fine, you can let go of that fear. And if you get screened and there’s something there, knowing at least allows that fear in many instances to be a little less, and we can work with you and start to help you down the road of the treatment you need, etc. But the unknown, the fear never leaves, and so you’re just in a constant state of fear. So I try to work with people on getting rid of that fear, and let’s do something about it.
– Well, doctor, some great information. We thank you so much for coming in and spending time with us today. We appreciate it.
– And thank you.
– I’m Tonia Caruso. Thank you for joining us. This is UPMC HealthBeat
If you are over 40 years old, a prescription is not required for a screening mammography.
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UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 70 locations throughout Pennsylvania, Ohio, New York, and Maryland, with more than 200 oncologists. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment.