Skip Navigation LinksEarly-Detection-and-Screening

Top Menu
Left Menu

Comprehensive cancer control program (CCCP)​

Doctor holding patient hand

Back to Comprehensive Cancer Control Plan ​​

​
​​

Chapter 5: Early Detection and Screening​

Early Detection and Screening: A Path to Saving Lives

Catching cancer early saves lives. This chapter focuses on raising awareness, making screenings more accessible, utilizing family history and genetic cancer risk assessment, and improving how care is delivered—especially for communities historically impacted by disparities in care.

Public Awareness and Education

Targeted, culturally and linguistically appropriate outreach and peer-to-peer education can increase understanding and trust in cancer screening. Community-led efforts and easy-to-understand materials help encourage more people to get screened at the appropriate time and interval.

Genetic Risk and High-Risk Surveillance

Understanding personal cancer risk is important. Some individuals are at higher risk for cancer due to their family history and/or a hereditary mutation. Collecting family cancer histories and expanding access to genetic cancer risk assessment and counseling can help identify high-risk individuals and ensure their risk is appropriately managed. It is also important to ensure that individuals who need these services can access them.

Communicating cancer risk to family members: Few individuals in low income and low resourced communities are aware of the important role of genetics and of communicating information to family members that can make a difference in their own early detection. Educational efforts focused on cancer risk communication can help families learn how to talk about cancer risk and catch it early.

Health Systems Improvements

Better coordination across health systems, improved reimbursement policies, and technology integration—such as interoperable records—can make screenings more accessible, affordable, and effective.

With better education, stronger partnerships, and expanded services, early detection efforts across California aim to detect cancer sooner, treat it more effectively, and save more lives.

Previous Page: Chapter 4: Priority 6: Alcohol | Next Page: Chapter 6: Treatment​

​
​​

References:

  1. Amboree, T. L., Montealegre, J. R., Parker, S. L., Garg, A., Damgacioglu, H., Schmeler, K. M., Chiao, E. Y., Hill, E. G., Sonawane, K., Deshmukh, A. A., & Adsul, P. (2024). National breast, cervical, and colorectal cancer screening use in federally qualified health centers. JAMA Intern Medicine, 184(6), 671-679. https://doi.org/10.1001/jamainternmed.2024.0693
  2. American Cancer Society. (2023, November 1). American Cancer Society Guidelines for the Early Detection of Cancer. https://www.cancer.org/cancer/screening/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html
  3. Centers for Disease Control and Prevention. (2024, May 23). Provider Assessment and Feedback Planning Guide. https://www.cdc.gov/cancer/php/ebi-planning-guides/provider-assessment-and-feedback-planning-guide.html
  4. D'Amico, T. A., Bandini, L. A. M., Balch, A., Benson, A. B., Edge, S. B., Fitzgerald, C. L., Green, R. J., Koh, W.-J., Kolodziej, M., Kumar, S., Meropol, N. J., Mohler, J. L., Pfister, D., Walters, R. S., & Carlson, R. W. (2020). Quality measurement in cancer care: A review and endorsement of high-impact measures and concepts. Journal of the National Comprehensive Cancer Network, 18(3), 250–259. https://doi.org/10.6004/jnccn.2020.7536
  5. Daly, M. B., Pal, T., Maxwell, K. N., Churpek, J. E., Zahraa Al‐Hilli, Arun, B. K., Buys, S. S., Cheng, H. H., Domchek, S. M., Friedman, S. J., Giri, V. N., Goggins, M., Hagemann, A. R., Hendrix, A., Hutton, M. L., Karlan, B. Y., Kassem, N., Khan, S., Khoury, K., & Kurian, A. W. (2024, November 7). Genetic/familial high-risk assessment: Breast, ovarian, pancreatic, and prostate version 2.2025. National Comprehensive Cancer Network. https://www.nccn.org/professionals/physician_gls/pdf/genetics_bopp.pdf
  6. Danylchuk, N. R., Cook, L., Shane‐Carson, K. P., Cacioppo, C. N., Hardy, M. W., Nusbaum, R., Steelman, S. C., & Malinowski, J. (2021). Telehealth for genetic counseling: A systematic evidence review. Journal of Genetic Counseling, 30(5), 1361-1378. https://doi.org/10.1002/jgc4.1481
  7. Gupta, S., Weiss, J. M., Axell, L., Burke, C. A., Chen, L.-M., Chung, D. C., Clayback, K. M., Felder, S., Foda, Z., Giardiello, F. M., Grady, W., Gustafson, S., Hagemann, A., Hall, M. J., Hampel, H., Hodan, R., Idos, G., Joseph, N., Kassem, N., & Katona, B. (2024, October 31). Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric. National Comprehensive Cancer Network. https://www.nccn.org/professionals/physician_gls/pdf/genetics_ceg.pdf
  8. Health Resources and Services Administration. (February 2025). Federal Cancer Collaborative Resources. https://www.hrsa.gov/office-womens-health/improving-cervical-cancer-care/resources
  9. National Association of Chronic Disease Directors. (2022). Mailed FIT implementation guide & online course. National Colorectal Cancer Roundtable. https://nccrt.org/resource/mailed-fit-implementation-guide/
  10. National Cancer Institute Division of Cancer Epidemiology & Genetics. (n.d.). Risk assessment tools and methods. https://dceg.cancer.gov/research/public-health-impact/risk-assessment
  11. National Colorectal Cancer Roundtable (n.d.). Messaging and communications hub. American Cancer Society. https://nccrt.org/resources/
  12. National Colorectal Cancer Roundtable. (2022). Steps for increasing colorectal cancer screening rates: A manual for community health centers. American Cancer Society. https://nccrt.org/resource/steps-for-increasing-crc-screening-rates-2022/
  13. National Colorectal Cancer Roundtable. (2024). Webinar: Public awareness strategies to promote colorectal cancer screening. American Cancer Society. https://nccrt.org/resource/webinar-public-awareness-strategies-to-promote-colorectal-cancer-screening/
  14. National Colorectal Cancer Roundtable. (n.d.). Improving screening rates: Promising practices for state-Medicaid agencies. American Cancer Society. https://nccrt.org/wp-content/uploads/dlm_uploads/Promising-Practices-for-State-Medicaid-Agencies-v08.pdf
  15. National Human Genome Research Institute. (2022, January 6). Genetic Discrimination. https://www.genome.gov/about-genomics/policy-issues/Genetic-Discrimination
  16. National Lung Cancer Roundtable. (2023). Accelerating uptake of lung cancer screening executive summary. American Cancer Society. https://nlcrt.org/resource/accelerating-uptake-of-lung-cancer-screening-early-detection-by-harnessing-it-and-electronic-health-records-executive-summary/
  17. National Lung Cancer Roundtable. (n.d.). Best practice guide for building lung cancer early detection programs. American Cancer Society. https://nlcrt.org/resource/best-practice-guide-for-building-lung-cancer-early-detection-programs/
  18. National Society of Genetic Counselors. (n.d.). Increasing access to genetic services and growing the genetic counseling workforce. https://www.nsgc.org/portals/0/docs/policy/Compendium_Increasing%20Access.pdf
  19. National Society of Genetic Counselors. (n.d.). Preventing harm: Gaps in patient and non-genetics provider's knowledge of genetics. https://www.nsgc.org/portals/0/docs/policy/Compendium_Preventing%20Harm.pdf
  20. Oh, A. Y., Emmons, K. M., Brownson, R. C., Glasgow, R. E., Foley, K. L., Lewis, C. C., Schnoll, R., Huguet, N., Caplon, A., & Chambers, D. A. (2022). Speeding implementation in cancer: The national cancer institute's implementation science centers in cancer control. Journal of the National Cancer Institute, 115(2), 131–138. https://doi.org/10.1093/jnci/djac198
  21. Onega, T., Alford‐Teaster, J., Leggett, C., Loehrer, A., Weiss, J. E., Moen, E. L., Pollack, C. C., & Wang, F. (2022). The interaction of rurality and rare cancers for travel time to cancer care. The Journal of Rural Health, 39(2), 426–433. https://doi.org/10.1111/jrh.12693
  22. Patel, M. I., Lopez, A. M., Blackstock, W., Reeder-Hayes, K., Moushey, E. A., Phillips, J., & Tap, W. (2020). Cancer disparities and health equity: A policy statement from the American Society of Clinical Oncology. Journal of Clinical Oncology, 38(29), 3439–3448. https://doi.org/10.1200/jco.20.00642
  23. PDQ® Cancer Genetics Editorial Board. (n.d.). PDQ cancer genetics risk assessment and counseling. National Cancer Institute. https://www.cancer.gov/publications/pdq/information-summaries/genetics/risk-assessment-hp-pdq
  24. Pegues, J. N., Isenberg, E. E., & Fendrick, A. M. (2024). The cost to breathe: Eliminating cost sharing associated with lung cancer screening. Annals of the American Thoracic Society. 21(6), 849-851. https://doi.org/10.1513/AnnalsATS.202401-064VP
  25. President's Cancer Panel. (2022, February 2). Goal 2: Facilitate Equitable Access to Cancer Screening. https://prescancerpanel.cancer.gov/reports-meetings/cancer-screening-report-2022/closing-gaps/goal2-equitable-access
  26. Siegel, R. L., Kratzer, T. B., Giaquinto, A. N., Sung, H., & Jemal, A. (2025). Cancer statistics, 2025. CA: A Cancer Journal for Clinicians, 75(1), 10-45. https://doi.org/10.3322/caac.21871
  27. Sirintrapun, S. J., & Lopez, A. M. (2018). Telemedicine in Cancer Care. American Society of Clinical Oncology Educational Book, 38, 540–545. https://doi.org/10.1200/edbk_200141
  28. Smith, G. L., Banegas, M. P., Acquati, C., Chang, S., Chino, F., Conti, R. M., Greenup, R. A., Kroll, J. L., Liang, M. I., Pisu, M., Primm, K. M., Roth, M. E., Shankaran, V., & Yabroff, K. R. (2022). Navigating financial toxicity in patients with cancer: A multidisciplinary management approach. CA: A Cancer Journal for Clinicians, 72(5), 437-453. https://doi.org/10.3322/caac.21730
  29. Yabroff, K. R., Reeder-Hayes, K., Zhao, J., Halpern, M. T., Lopez, A. M., Bernal-Mizrachi, L., Collier, A. B., Neuner, J., Phillips, J., Blackstock, W., & Patel, M. (2020). Health insurance coverage disruptions and cancer care and outcomes: Systematic review of published research. Journal of the National Cancer Institute, 112(7), 671–687. https://doi.org/10.1093/jnci/djaa048

Resources:

  1. American Academy of Family Physicians (AAFP), "Developing Standing Orders to Help Your Team Work to the Highest Level" - https://www.aafp.org/pubs/fpm/issues/2018/0500/p13.html
  2. American Cancer Society (ACS), Position Statement on the Elimination of Patient Cost-Sharing Associated with Cancer Screening and Follow-up Testing - https://www.cancer.org/health-care-professionals/american-cancer-society-prevention-early-detection-guidelines/overview/acs-position-on-cost-sharing-for-screening-and-follow-up.html#:~:text=It%20is%20the%20position%20of,follow%2Dup%20tests%20described%20as
  3. Breast and Colorectal Cancer Screening Implementation Project (BCCSIP) - https://www.cacoloncancer.org/bccsip-cycle-i-funding-announcement/
  4. California Academy of Family Physicians (CAFP) - https://www.familydocs.org/
  5. California Department of Health Care Services (DHCS) Medi-Cal Resources - https://www.dhcs.ca.gov/services/medi-cal/Pages/default.aspx
  6. California Department of Health Care Services (DHCS), Every Woman Counts (EWC) - https://www.dhcs.ca.gov/services/Cancer/ewc/Pages/default.aspx
  7. California Healthcare Quality Report Cards, Preventive Screenings Summary - https://reportcard.opa.ca.gov/rc/hmo_ppo_combinedTopic.aspx?Category=HMO_PPOHEDIS&Topic=PreventionandScreenings
  8. California Medical Association (CMA) - https://www.cmadocs.org/
  9. Center for Data Insights and Innovation (CDII) Data Exchange Framework (DxF) - https://www.cdii.ca.gov/
  10. Center for Data Insights and Innovation (CDII) Data Exchange Framework (DxF), DxF 2025 Implementation - https://www.cdii.ca.gov/committees-and-advisory-groups/data-exchange-framework/
  11. Centers for Disease Control and Prevention (CDC), "Patient Navigation" - https://www.cdc.gov/cancer/php/interventions/patient-navigation.html
  12. Centers for Disease Control and Prevention (CDC), "Provider Assessment and Feedback" - https://www.cdc.gov/cancer/php/interventions/provider-assessment-and-feedback.html
  13. Centers for Disease Control and Prevention (CDC), "Reducing Structural Barriers Planning Guide" - https://www.cdc.gov/cancer/php/ebi-planning-guides/reducing-structural-barriers-planning-guide.html
  14. City of Hope (COH), Intensive Course in Genetic Cancer Risk Assessment - https://www.cityofhope.org/ic
  15. Health Information National Trends Survey (HINTS) - https://hints.cancer.gov/
  16. Jackson Lab “Family History Collection and Risk Assessment" - https://www.jax.org/education-and-learning/clinical-and-continuing-education/clinical-topics/family-history
  17. Journal International American Medical Informatics Association (JIAMIA), " Optimizing Best Practice Advisory alerts in electronic medical records with a multi-pronged strategy at a tertiary care hospital in Singapore Open Access" - https://academic.oup.com/jamiaopen/article/6/3/ooad056/7235064
  18. Journal of General Internal Medicine (JGIM), "Revisiting the Time Needed to Provide Adult Primary Care" - https://link.springer.com/article/10.1007/s11606-022-07707-x
  19. Kaiser Foundation Family (KFF), State Health Facts "Medicaid-to-Medicare Fee Index" - https://www.kff.org/medicaid/state-indicator/medicaid-to-medicare-fee-index/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
  20. MedlinePlus Genetics - https://medlineplus.gov/genetics/
  21. National Cancer Institute, “Genetic Testing for Cancer Risk" - https://www.cancer.gov/about-cancer/causes-prevention/genetics/genetic-testing-fact-sheet
  22. National Society of Genetic Counselors, “Find a Genetic Counselor" - https://findageneticcounselor.nsgc.org/
  23. The Commonwealth Fund, "How Differences in Medicaid, Medicare, and Commercial Health Insurance Payment Rates Impact Access, Health Equity, and Cost" - https://www.commonwealthfund.org/blog/2022/how-differences-medicaid-medicare-and-commercial-health-insurance-payment-rates-impact
Page Last Updated :