Does an innovative program improve access to cancer screening for people without a family doctor?
In France as in Canada, millions of people do not have a family doctor. This situation makes it difficult to access cancer screening, which is essential for early detection of diseases and reducing deaths. An experiment conducted in the Champlain region of Ontario shows that it is possible to address this issue through a proactive and centralized approach.
A pilot program enabled more than 500 people without a doctor to receive screening for breast, colon, lung, and cervical cancer. A specialized nurse, called a “super screener,” conducted consultations by phone. She prescribed the necessary tests and followed up on the results. In one year, 786 screening tests were performed. Among the participants, 36% had never been screened before.
The results are striking: the rate of anomaly detection was much higher than the provincial average. For example, 28% of colon screenings revealed polyps or cancers, compared to only 4% under normal circumstances. For breast cancer, 13% of mammograms showed abnormalities, nearly double the usual rate. These figures are partly explained by the fact that the program targeted populations often overlooked by traditional campaigns. Most participants lived in disadvantaged neighborhoods, with a high proportion of immigrants and visible minorities.
The program also identified more high-risk individuals. Nearly 42% of participants eligible for in-depth colorectal cancer screening were referred for specialized exams, compared to only 2.6% on average in the province. For breast cancer, this rate reached 27%, compared to 1.1% elsewhere. These differences show that traditional methods miss cases that deserve special attention.
Another important lesson concerns people who had never been screened before. They often lived in unstable neighborhoods, where frequent changes of residence and lack of social support make access to care more difficult. The program thus revealed that the absence of regular medical follow-up worsens inequalities in the face of disease.
The cost per consultation was approximately 200 euros, an investment that could be offset by the savings achieved through early cancer detection. Indeed, treating advanced-stage cancer is much more expensive than early screening. Organizers also point out that this type of initiative could be extended to other regions, or even to other countries facing a shortage of general practitioners.
The originality of this program lies in its simplicity: participants could make appointments online or by phone, without needing to go through a doctor. The exams were organized in community health centers, and the results were centralized to prevent loss of follow-up. Close collaboration with local associations made it possible to reach populations that are usually difficult to access, such as immigrants or precarious individuals.
This experiment proves that it is possible to reduce inequalities in screening, even during a primary care crisis. It paves the way for concrete solutions to improve prevention and save lives.
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About This Study
DOI: https://doi.org/10.17269/s41997-026-01169-y
Title: An ounce of “superscreener”: A novel cancer screening program targeting unattached individuals
Journal: Canadian Journal of Public Health
Publisher: Springer Science and Business Media LLC
Authors: Anna N. Wilkinson; Kate Volpini; Amriya Naufer; Andrea Miville; Chantal Lalonde; Erika Kamikazi; Sarah Hepworth-Junkin