Minh Nguyen, fourth-year medical student at Oregon Health and Science University School of Medicine, contributed this article.
Closing gaps in cancer screening requires more than expanding appointment slots or improving referral pathways. It requires a thoughtful strategy focused on where, how and with whom care is delivered.
A growing collection of community-based outreach initiatives at Oregon Health & Science University (OHSU) is redefining access and equity in cancer screening to show that trust, cultural relevance and proximity are just as essential as clinical quality.
The Pink & Pearl Campaign, an initiative promoted by the ACR®, is carried out at OHSU as an annual event co-led with culturally specific community organizations. It has become a case study in how meeting patients where they are — geographically, culturally and financially — can transform access to cancer screening for a community’s most underserved groups.
Traditional healthcare systems assume patients will come into clinics to receive preventive care. But this expectation is often unrealistic — and inequitable. “For many communities of color, healthcare settings are not places where they feel a sense of belonging or safety,” says Brian Park, MD, MPH, Associate Professor of Family Medicine and Medical Director of the OHSU Health Equity Organization.
Geographic distance, financial and logistical barriers, and a long history of medical exclusion all contribute to lower screening uptake among the very communities at highest risk. OHSU Health Equity is intentionally shifting this paradigm. Rather than asking patients to enter unfamiliar spaces, the team focuses on embedding healthcare activities within community settings where people already feel comfortable.
In this model, community organizations serve as co-leaders, rather than outreach sites, which strengthens trust and ensures that interventions align with community priorities.
This is not just relocation of services — it is about honoring where identity, trust and cultural belonging already live.
Now in its second year, the OHSU Pink & Pearl Campaign brings breast and lung cancer screening education directly into culturally specific community spaces. The event provides on-site mammography scheduling, lung cancer risk conversations, navigation support and culturally tailored education delivered in multiple languages.
Campaign feedback and survey responses over the years highlight recurring themes:
The Pink & Pearl Campaign demonstrates that effective screening outreach is not just educational but also ensures that care is accessible, relevant, dignified and community driven.
By embedding healthcare within culturally specific community-based settings, we’ve been able to build authentic bridges with community organizations, strengthen trust and begin to shift power back to communities themselves.
Bringing screening to the community is only one part of the equation. Once patients enter the health system, clinical environments must also support cultural safety, linguistic access and affirming care. Katherine Cavallo-Hom, MD, Assistant Professor of Diagnostic Radiology, Women’s Imaging Section, notes several ongoing initiatives within the OHSU Breast Center:
These efforts ensure that culturally responsive outreach leads seamlessly into culturally responsive clinical care. Trust is strengthened when every step of the screening journey, from outreach to the exam room, reflects respect for each patient’s cultural and personal needs.
OHSU’s experience highlights a few central principles for improving cancer screening equity:
These strategies transform screening from a system-driven task into a community-centered process.
Rather than centering institutional assumptions about what communities ‘should’ learn or receive, we need to follow the lead of culturally specific organizations to identify what matters most to their members — and then partner with them to deliver services in ways that are linguistically responsive, culturally grounded and community-owned.
Through outreach efforts like the Pink & Pearl Campaign and the daily work of teams across OHSU, screening is not simply being expanded. It is being reimagined.
For more screening information and patient resources, please access ACR mammography and breast imaging resources and lung cancer screening resources. In addition, you might consider signing up to participate in the national initiative, Communities Crushing Cancer, on Oct. 28, to join other students as well as radiology residents within your own community to raise cancer awareness and increase cancer screening rates.
Physician Groups Warn Visa Delays Could Impact Patient Care
More than 30 medical organizations, including the ACR®️, urged federal officials to address immigration barriers preventing international medical graduates (IMGs) from lawfully entering or remaining in the U.S.
Read moreHidden Curriculum of Outreach
The hidden curriculum of volunteerism and outreach helps medical students build indispensable skills in communication, teamwork and leadership.
Read moreDebunking Pediatric Radiology Myths
Find out the truth about careers in pediatric radiology, including training pathways, compensation, imaging modalities, patient interaction and clinical impact.
Read more
