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.
Rethinking Access: When Patients Don’t Feel at Home in Clinical Settings
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.
Brian Park, MD, MPH
Pink & Pearl: A Case Study in Community-Driven Screening Outreach
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:
- Trust precedes education. People engage more openly when surrounded by familiar faces and culturally affirming environments.
- Culturally responsive materials matter. Visuals and language that reflect community identity increase understanding and comfort.
- Navigation support reduces burden. For many, on-site scheduling is the difference between screening and continued delay.
- Bundling services increases reach. Breast and lung screening conversations reinforce each other, expanding awareness for entire families.
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.
Brian Park, MD, MPH
Culturally Responsive Care Within the OHSU Breast Center
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:
- Gender-affirming and LGBTQ+-inclusive care
- Annual competency and training sessions with the OHSU Transgender Health Program
- Staff discussions and focus groups on gender-affirming language
- Outreach and education during Portland Pride 2025
- Linguistic and cultural accessibility
- In-person interpreters for all procedures
- Translated patient materials
- Respecting cultural and religious preferences in provider assignments
- Community partnerships and safety-net access
- On-site education at community clinics (Outside In, Multnomah County Health, La Clinica Buena Salud and Planned Parenthood)
- Collaboration with the Oregon Health Authority ScreenWise
- Breast Health for All — 100% coverage for uninsured and underinsured patients to access screening mammography
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.
What Health Systems Can Learn
OHSU’s experience highlights a few central principles for improving cancer screening equity:
- Bring education into trusted community spaces
- Allow community partners to serve as co-leaders, not just outreach sites
- Honor language, gender identity and cultural values in clinical care
- Integrate navigation support and on-site scheduling
- Bundle education for multiple screening types when possible
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.
Brian Park, MD, MPH
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.
