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Community-Based Screening Programs
The Baltimore City Health Department, in its 1999 Annual Report, cited cancer as the leading cause of death among African-American males. This report, as well as the Maryland Department of Health’s Baseline Cancer Report in August 2000, confirmed that African-Americans bear a disproportionate share of the cancer burden. The disparity in prostate cancer incidence and mortality rates for Baltimore City is among the greatest nationwide. The Johns Hopkins Cigarette Restitution Fund (CRF) Public Health Grant addressed this public health problem by focusing on prostate cancer in Baltimore’s African-American and other medically underserved populations. Cancer prevention, by both education and screening, was conducted through collaborations with community-based and faith-based partners throughout Baltimore City.
Under the direction of the Baltimore City Community Health Coalition, Hopkins clinicians collaborated with colleagues at the University of Maryland, the Baltimore City Health Department, and the Maryland’s Department of Health and Mental Hygiene (DHMH) to achieve the goals of the Baltimore City Cancer Plan at Johns Hopkins (BCCP). The BCCP provided no-cost prostate cancer education, screening, diagnosis and treatment for uninsured and underinsured residents of Baltimore City. Community-based and Hopkins-based physicians performed prostate cancer screening that involved two tests: 1) a blood test that detects the prostate specific antigen or PSA, and 2) a digital rectal exam or DRE. The testing was done at various community sites and clinics (including Wald Clinic, Shepherd’s Clinic, East Baltimore Medical Center (EBMC), and Baltimore City Housing and Development). Case management and necessary follow-up care or treatment was also provided.
Hopkins broadened its program to include community education, screening, diagnosis and treatment of breast cancer through a grant from the Avon Foundation. Johns Hopkins also offered similar services for colorectal cancer, through a project grant from the Centers for Disease Control (CDC) to DHMH. Through this program, five local Hospitals, including Johns Hopkins provided no-cost colon cancer screening for uninsured and underinsured residents of Baltimore City. Currently, faculty from the Johns Hopkins gastrointestinal program collaborate with representatives from the Baltimore City Health Department through its CRF Public Health Grant to provide colonoscopy screening to uninsured Baltimore residents.
The Kimmel Cancer Center no longer receives direct CRF support for cancer screening in uninsured and minority populations, but it remains a key initiative for our Center. Johns Hopkins Priority Partners, a Medicaid MCO with more than 185,000 participants, and Johns Hopkins community physicians, who care for more than 260,000 patients, continue to meet the needs of Maryland’s underserved populations by providing screenings for colon, prostate, breast, and cervical cancers.