TACHC and CHPPR Assist Texas Health Centers to Implement Cancer Prevention Strategies

The Texas Association of Community Health Centers (TACHC) is Texas’s federally designated primary care association, committed to advancing equitable access to quality healthcare in Texas. The Center for Health Promotion and Prevention Research regularly partners with TACHC on cancer and chronic disease prevention projects across the state, including HPV vaccination, smoking cessation, and colorectal and cervical cancer screening programs.

Existing disparities in cancer prevention and outcomes worsened during the COVID-19 pandemic, when cancer screening rates decreased across the board. TACHC, in conjunction with CHPPR and other partners throughout Texas, works to bridge this health care gap through a number of programs implemented in Federally Qualified Health Centers (FQHCs). FQHCs serve populations that have traditionally been under-resourced and therefore remain at high risk for being unscreened and developing cancer, with 40% of their greater than 1.6 million patients being uninsured. These health centers are critical as the primary care safety net to achieve efforts to improve cancer screening rates and reduce screening inequities.

Successful strategies that FQHCs have implemented include:

HPV Vaccination Learning Communities: HPV vaccination can prevent six different types of cancer and is most cost effective when administered prior to sexual debut. With support from the American Cancer Society (ACS), participating health centers have developed learning communities that have enabled them to improve HPV vaccination initiation and completion beginning with patients as young as 9. These health centers have been able to improve screening rates despite the pandemic.

Smoking Cessation Programs: Tobacco use causes numerous cancers, including lung, larynx, oral, multiple urinary tract and GI tract cancers, making smoking cessation a long-standing priority for health centers. Several FQHCs have partnered with Taking Texas Tobacco Free to implement SBIRT (Screening, Brief Interventions, and Referral to Treatment) to train staff on strategies and motivational interviewing. This smoking cessation support has been successful, with 85.57% of health center patients assessed for tobacco use and provided with an intervention.

Colorectal Cancer Screening: Only 32.24% of patients were up to date on colorectal cancer (CRC) screenings in 2020, this declined from 38.64% the previous year and far from the Healthy People 2020 goal of 70.50%. Several health centers are partnering with Cancer Prevention and Research Institute of Texas (CPRIT) initiatives to improve these screening rates through mailed fecal immunochemical testing (FIT) through registries of patients who have not yet completed CRC screening. 

Cervical Cancer Screening: Rates of cervical cancer screening through Pap and HPV-testing declined from 58.15% in 2019 to 54.35% in 2020, far from the Healthy People goal of 93%.  Since 2019, several health centers have partnered with the MD Anderson CPRIT program “Expansion of cervical cancer prevention services to medically underserved populations through patient outreach, navigation & provider training/telementoring.” The program has included hands-on colposcopy and 6 LEEP training courses, which allowed 22 health center providers to be fully trained. A total of 102,258 women have received education about cervical cancer screening and HPV vaccination through the CPRIT team and nearly 40,000 women have been screened for cervical cancer with Pap and/or HPV testing.

You can learn more about TACHC and the work they are doing across Texas at their website.