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The Cancer Screening Project

The Cancer Screening Project

Today, people with human immunodeficiency virus (HIV) are living longer and aging because of HIV treatment (antiretroviral therapy or ART). However, people with HIV are more at risk for cancer, but less likely to get screened, treated, or survive.1

The Cancer Screening Project (CaSPr) aims to help by offering free coordination and navigation services for colorectal, cervical, breast, and lung cancer to people with HIV in Michigan.
 

Women of varying ages and ethnicities seated in circle and listening as one member of the group talks

  • In order to refer a patient or client to CaSPr, follow the steps listed below. 

    1. Have the patient or client sign your organization’s release of protected health information to:

      The Cancer Screening Project
      Cancer Prevention and Control Section
      320 S. Walnut St.
      Lansing, MI 48933
      Phone: 517-512-5041
      Fax: 517-763-0290

    2. Fill out the Cancer Screening Project (CaSPr) Fax Cover Sheet and include your name, the number of pages being sent, a phone number that you can be reached at, and today’s date.
    3.  Place the CaSPr Fax Cover Sheet on top and fax to 517-763-0290.

    You will receive a phone call verification once the document has been received by the CaSPr Navigator. CaSPr aims to complete phone call verifications within 24 hours.

  • Coordination

    Coordination services includes providing resources such as the name of a health care organization or provider that can complete the cancer screening recommended for you.

    Resources might include:

    • Cancer screening locations for all 83 counties in Michigan.
    • HIV experienced and health equity trained primary care provider resources.
    • Cancer screening resources in all 83 counties of Michigan.

    Navigation

    Navigation services includes the process of completing a CaSPr Assessment, service plan, and objectives dealing specifically with one or more of the following cancer screenings: colorectal, cervical, breast, and lung cancer. Navigation services must include a CaSPr Assessment, service plan, and at least one additional service from the options listed below:

    • Assessment: activities related to completing biopsychosocial assessment and acuity scale, completing consents and releases (if applicable).
    • Service Plan Development: activities related to completing the service plan at assessment or reassessment; this must be done every six months at minimum.
    • General Support: activities that do not easily fit into other categories listed here; can include: listening to client, providing support, advocating on client’s behalf, etc.
    • Treatment Adherence: activities related to assessing and addressing medication adherence issues.
    • Reassessment: activities related to updating client’s biopsychosocial areas and acuity scale, updating eligibility information, updating consents and releases (if applicable).
    • Monitoring: activities related to monitoring client’s service plan needs.
    • Discharge: activities related to terminating client’s services; can include discussing discharge with client and paperwork related to discharge.
    • HIV Specialist Confirmed: activities related to confirming that a client has attended a medical visit; only one unit should be used for each event. Confirming medical visits should not be done by client self-report alone, but verified with a medical clinic/provider to guarantee attendance. This unit must be entered for the date that the client attended the medical appointment, not for the date the appointment was verified.
    • Referral: activities related to providing a referral of ANY type, advocating on client’s behalf regarding referral, following up with referral source or client on referral outcome, and confirming referral was actualized.
    • Care Coordination: activities related to supervision, case conference, contact with client’s providers related to coordinating client’s service.
    • Health Education/Risk Reduction: activities related to assessing and addressing client’s risk reduction issues related to HIV, colorectal, cervical, breast, or lung cancers.
    • Housing Assistance: support for housing services that involve the provision of short-term assistance to support emergency, temporary or transitional housing to enable an individual or family to gain or maintain medical care and/or cancer screening services.
    • Psychosocial Support: support for psychosocial support services that may include support and counseling activities; child abuse and neglect counseling; HIV support groups, cancer support groups; pastoral care/counseling; caregiver support; bereavement counseling.
    • Transportation Assistance: medical transportation service assistance that enables an eligible individual to access HIV related health support services, including services needed to maintain the client in HIV medical care, or cancer screening services through either direct transportation services, health insurance transportation assistance, and county health departments transportation assistance programs, etc. May be provided through use of volunteer drivers (through programs with insurance and other liability issues specifically addressed).

  • Risk Factors:

    Factors that increase risk of breast cancer for people assigned female at birth include:

    • Personal or family history of breast or ovarian cancer.
    • Dense breast tissue.
    • Starting menstruation at a young age.
    • Never giving birth or having first pregnancy after age 30.
    • Alcohol consumption.
    • Specific genetic mutations (e.g. BRCA1 or BRCA2).
    • Getting older. Breast cancer risk increases with age.
      • Most breast cancers are diagnosed after age 50.
    • Previous treatment using radiation therapy, specifically for women who had radiation therapy before the age of 30.
    • Exposure to the drug diethylstilbestrol (DES).

    People assigned male at birth can get breast cancer too, representing about 1% of new cases in Michigan from 2012-2016. Things that increase risk of breast cancer for people assigned male at birth include:

    • Family history.
    • Genetic mutations.

    Everyone should talk to their health care provider about their risk for breast cancer. 

    Sources:

    Who Should Get Screened?

    • The U.S. Preventive Services Task Force recommends screening for breast cancer for people assigned female at birth, of average risk, from age 40 through age 74, every two years.
      • If risk factors are present, screening may be needed before the age of 40. Ask your health care provider for more information.
    • What does this screening look like?
      • For those ages 40 and older, regular screening mammogram should be administered at intervals based on risk factors (usually every one to two years).
      • Different screening recommendations may be used for women at higher-than-average risk.
      • For those at high risk of breast cancer, a breast MRI (magnetic resonance imaging) and mammogram annually may be recommended.

    Sources:

    How Can I Get screened?

    • Under the Affordable Care Act (ACA), mammograms are covered by many insurances as part of preventive health care. Ask your health care provider for more information.
    • Breast & Cervical Cancer Control Navigation Program (BC3NP) provides breast cancer screening to low-income, uninsured individuals between the ages of 40 and 64 years and also assists insured individuals in scheduling mammogram if needed. For more information about the BC3NP, please call toll free 844-446-8727 (interpreters available) or visit BC3NP to see if you qualify.
    • The CaSPr Navigator can provide resources for questions that you might have about HIV and breast cancer screening. You can contact the CaSPr Navigator at 517-512-5041.

    Source:

  • Risk Factors:

    • Infection with one or more strains of human papilloma virus (HPV).
      • About 90% of cervical cancers are associated with HPV.
    • Smoking cigarettes.
    • Having HIV (the virus that causes AIDS) or another condition that makes it hard for your body to fight off health problems.

    Source:

    Who Should Get Screened?

    • Screening for cervical cancer is recommended for anyone with a cervix, who is of average risk between the ages 21-65.
    • What does this screening look like?
      • For anyone with a cervix aged 21 to 29, Pap tests should be administered every three years.
      • For anyone with a cervix aged 30 to 65 it is recommended to be screened every three years with a Pap test, OR every five years with high-risk HPV testing alone, OR every five years with hrHPV testing in combination with a Pap test (co-testing).

    Sources:

    How Can I Get Screened?

    • Pap tests are available at family planning clinics, obstetrician gynecologist (OBGYN) offices, and most primary care clinics. Under the Affordable Care Act (ACA), these screenings are covered by many insurances. Ask your health care provider from more information.
    • Breast & Cervical Cancer Control Navigation Program (BC3NP) provides cervical cancer screening to low-income, uninsured individuals between the ages of 21-64. For more information about the BC3NP, please call toll free 844-446-8727 (interpreters available) or visit BC3NP to see if you qualify.
    • The CaSPr Navigator can provide resources for questions that you might have about HIV and cervical cancer screening. You can contact the CaSPr Navigator at 517-512-5041.

    Source:

  • Risk Factors:

    • Cigarette smoking is the number one risk factor for lung cancer.
    • Radon is a leading cause of lung cancer in the United States (U.S.).

    Source:

    Who Should Get Screened?

    • The U.S. Preventive Services Task Force recommends yearly lung cancer screening with low dose computed tomography (LDCT) scan for people who:
      • Have a 20 pack-year* or more smoking history, and
      • Smoke now or have quit within the past 15 years, and
      • Are between 50 and 80 years old.

    * A pack-year is smoking an average of one pack of cigarettes per day for one year. For example, a person could have a 20 pack-year history by smoking one pack a day for 20 years or two packs a day for 10 years.

    Source:

    How Can I Get Screened?

    • CaSPr encourages you to speak with your health care provider about your need for cancer screening services. An individual's age, family history, smoking history, personal life choices, physical ability, and many other factors affect the need for screening and that is why we ask that you speak with a health care provider.
    • Most health plans must cover a set of preventive services — like shots and screening tests. This includes plans available through the Health Insurance Marketplace. These services are covered only when delivered by a health care provider in your plan’s network. If you have insurance questions, please contact the CaSPr Navigator at 517-512-5041.

    Source:

  • Risk Factors:

    • Risk of getting colorectal cancer increases as one gets older.
    • Having:
      • Inflammatory bowel disease, colitis.
      • Personal or family history of colorectal cancer or colorectal polyps; and/or
      • Genetic syndrome, such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).
    • Lifestyle risk factors:
      • Lack of regular physical activity.
      • Diet low in fruit and vegetables.
      • Low-fiber and high-fat diet, or a diet high in processed meats.
      • Overweight and obesity.
      • Alcohol consumption.
      • Tobacco use.

    Source:

    Older woman standing behind an older man seated on a couch and hugging him from behind

    Who Should Get Screened?

    • The U.S. Preventive Services Task Force recommends people ages 45 to 75 be screened for colorectal cancer. People at an increased risk of getting colorectal cancer should talk to their health care provider about when to begin screening, which test is right for them, and how often to get tested. If you are older than 75, talk to your health care provider about screening.

    Screening tests include:

    • Stool Tests
      • Guaiac-based fecal occult blood test (gFOBT) 
      • Fecal immunochemical test (FIT) 
      • FIT-DNA test 
    • Colonoscopy 
    • Flexible Sigmoidoscopy 
    • CT Colonography (Virtual Colonoscopy)

    Source:

    How Can I Get Screened?

    • CaSPr encourages you to speak with your health care provider about your need for cancer screening services. An individual's age, family history, sexual history, personal life choices, physical ability, and many other factors affect the need for screening and that is why we ask that you speak with a health care provider. 
    • Most health plans must cover a set of preventive services — like shots and screening tests. This includes plans available through the Health Insurance Marketplace. These services are covered only when delivered by a health care provider in your plan’s network. If you have insurance questions, please contact the CaSPr Navigator at 517-512-5041.

    Source:

  • If you have questions about CaSPr, please contact MDHHS-cancerscreeningproject@michigan.gov or 517-512-5041.

    Host a Training/Lunch and Learn

    If you would like to host a training or lunch and learn, please reach out to MDHHS-cancerscreeningproject@michigan.gov.

1 Theresa W. Gillespie, Loree Mincey, Yuan Liu, Denise Ballard, Kimberly W. Scott, Robert Knott, Minh Ly T. Nguyen, Saurabh Chawla, Joseph Lipscomb, Jessica H. Wells. Survivorship care plan for cancer prevention and screening for people living with HIV (PLWH) [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-024.