Summarize this content to 2000 words in 6 paragraphs Earlier this year, Juanita Thomas, 63, went to her local Department of Motor Vehicles to register a car.For Thomas — a retired housekeeper, mom, grandmother and great-grandmother in Omaha, Nebraska — cancer was the last thing on her mind that day. But, while at the DMV, she was approached no fewer than three times by people offering her a free colorectal cancer screening kit. Finally, she relented. “I brought it home, and I sat it down and looked at it for a couple of days before I even used it,” Thomas tells TODAY.com. It wasn’t until her kids brought up “Black Panther” actor Chadwick Boseman, who died at age 43 due to colon cancer, that Thomas was finally convinced to take the test.The kit, a fecal immunochemical test (FIT) that detects blood in stool, was easier to take than she expected. Using a pre-paid envelope, she mailed it to a lab for analysis. Thomas couldn’t see anything wrong with her sample herself, so she was shocked to receive a call later that the lab had actually found blood in her stool.”I had no clue — none at all. I felt fine,” she says. “That’s why I kept turning down the test.” Thomas then went for a colonoscopy, accompanied by her daughter, which “took away the nervousness,” she says. During the procedure, doctors detected and removed eight polyps from her colon and rectum. While most colon polyps are harmless, some can develop into cancer if left untreated, the Mayo Clinic says.In Thomas’ case, the team found no cancer. Looking back, Thomas says she’s glad the people in the DMV were so persistent because the procedure revealed those polyps — and reassured her that she didn’t have colon cancer. “I came out of there feeling like a whole new person,” she says.An innovative example of community outreachThomas is just one of about 340 people who were tested for colon cancer through the BEAT Cancer project, which stands for Black Equity, Access and Testing for Cancer. She’s one of 21 participants whose test results came back positive and one of six who underwent a follow-up colonoscopy.The study aims to use the DMV — both the physical space and its roster of data — to offer free colorectal cancer screening to people from underserved communities. “I’ve done cancer screening research for the past 10 years, and … one thing that really bothers me is that cancer screening aid is not equal to everybody,” study lead Jungyoon Kim, Ph.D., associate professor in the department of health services and administration at the University of Nebraska Medical Center, tells TODAY.com.One statistic in particular always stood out to her: Black Americans are about 20% more likely to be diagnosed with colon cancer than other racial groups — and they’re 40% more likely to die due to colon cancer as well, according to the American Cancer Society.”That was really surprising to me,” she says. “I was wondering, OK, in my community, is there anything I could do to decrease this?” Partnering with an advisory board of local groups, including Douglas Country Treasurer John Ewing, the Great Plains Colon Cancer Task Force and Charles Drew Health Center, Kim set out to reach people who don’t always get the care they deserve — and set out to meet them at the DMV instead of a doctor’s office.While the DMV is a state agency, individual county treasurers’ offices provide DMV services, Ewing tells TODAY.com. As someone who’s volunteered with local efforts like Sunshine Kids and events for the Leukemia and Lymphoma Society, Ewing says the partnership just made sense — both as a way to improve access to colon cancer testing and as part of a strategy to change the way people interact with offices like his. “It’s not government as usual,” he says. “It’s more innovative. And it’s looking at: How do we become better partners with the community?”Research staff set up booths at the DMV and in the lobby of Ewing’s office building to speak to people and hand out FIT kits. The staff is also using DMV driver’s license data to mail kits to eligible participants in certain age and racial groups in the area, Kim explains. That data is surprisingly rich — and captures about 90% of the population in the area, she says.With funding from Robert Wood Johnson Foundation, the test kit is entirely free for participants. “You don’t even have to pay postage because (you) can just use the prepaid envelope,” Kim says. If any follow-up care is required, like a colonoscopy, insurance should cover it, Bailey Cooper, board secretary for the Great Plains Colon Cancer Task Force and oncology nurse at the Nebraska Medicine Buffett Cancer Center, tells TODAY.com. And for those without insurance, community health navigators are able to connect participants with low- or no-cost care at the health center, Kim explains. About 40% of the participants in the study reported that they didn’t have a primary care doctor and 25% did not have insurance, she says. For instance, if participants don’t have “a medical home” as they’re going through this process, staff may direct people to the Charles Drew Health Center, a federally qualified health center, Ewing says. (Ewing is also the health center’s board chairperson.)Addressing disparities in health care means meeting people where they areHanding out test kits at the DMV is an “innovative and exciting” approach, Scherezade K. Mama, Dr.PH., assistant professor in the department of health disparities research at the University of Texas MD Anderson Cancer Center, tells TODAY.com.Mama (who is not involved with the BEAT Cancer study) and her colleagues have experience setting up study outreach in Texas at tax preparation events and working with local pastors. Transportation, distance and child care coverage are major concerns for the low-income and rural populations Mama works with, “so we’re meeting them where they are or where they’re already going rather than requiring an additional trip,” Mama explains. In the same way, using the DMV as a space to meet those who might fall through the cracks of the typical medical system “could have high impact,” Mama says. Until now, though, the DMV seems to have been overlooked as a place to reach those folks. “I’ve never heard anything happen at the DMV before,” Mama says.Ewing agrees: “I’ve never heard of anybody else doing it. But I want us to be different.”It will be particularly interesting to see how many people actually follow through on taking the tests and whether participants are more likely to respond to the kits obtained in person or through the mail, Mama says. Indeed, the biggest challenge has been with follow-ups for people who have positive FIT results, Cooper says. “Sometimes it’s really hard to get a hold of someone, usually by telephone,” she explains. “There’s a very real fear of, ‘Well, what will I find out with further testing? I’d rather just not know.’”Ewing adds: “There’s a lot of burying your head in the sand and thinking everything’s OK or hoping it will go away.” People may simply not know that they should be getting screened for colon cancer at their age or that the cost of screening should be covered by insurance. Educating the public about these topics is another way outreach projects like this can help address racial disparities in medicine, Ewing adds.While there may be more kits mailed out than handed out, “that personal touch and experience — having a face and a name and somebody to actually talk to — can make all the difference,” Mama says.Cooper has a similar hunch: “Through the DMV approach, there’s a face-to-face interaction, a conversation,” she says. “But if you just see it online or a printout, it doesn’t really hit home.” Having someone directly in front of you to answer questions as they come up “can definitely be more effective (than mailing),” she adds.However the data ultimately shakes out, this study “could give us more information on where you get the biggest bang for your buck,” Mama says, which can help direct future outreach efforts.Even if the project only helps a few people, “it’s still someone”The project began initially with a small pilot study in 2021, followed by the current clinical trial, which began outreach in October 2023, Kim says. Now, the team is gearing up for another round of outreach beginning Sept. 1, with an added focus on social media advertisements to drive participants to the in-person sites.“I would love if this could continue,” Cooper says. “We’d love to work on it as long as we can because, even if it (helps) just a small number of people, it’s still someone.”While the task force provides free test kits every March for colorectal cancer awareness month, she says, this project would help them reach community members throughout the year.Ewing also hopes the project is able to continue, but says there’s potential to branch out into other health topics as well. Maybe the DMV space is used for colon cancer outreach for a few months followed by breast cancer or stroke awareness, he says.After her colonoscopy, Thomas won’t need another one for three years, she says, and she encourages others to “definitely take the test. … It’s annoying. But in the long run, it’s worth it.” But, for now, she’s looking forward to enjoying the rest of her “polyp-free summer,” she says.
