Meeting communities where they are: Expanding access to colorectal cancer screening in Minnesota
The power of early detection
March is recognized as Colorectal Cancer Awareness Month, a time to highlight the importance of prevention, early detection, and equitable access to screening. Colorectal cancer remains one of the most commonly diagnosed cancers in the United States and a leading cause of cancer-related death. In Minnesota, it is the fourth most common cancer, underscoring its continued impact across the state. Yet it is also one of the most preventable cancers when detected early through routine screening.
Screening can identify colorectal cancer at its earliest stages, when treatment is most effective, and can even prevent cancer altogether by detecting and removing precancerous growths. National guidelines now recommend that adults begin regular screening at age 45.
Despite these advances, screening rates vary widely across communities. Differences in access, awareness, and healthcare resources mean that many individuals remain unscreened. In Minnesota, these disparities highlight the need for approaches that make screening more accessible and responsive to community needs.
Understanding the gap: Community needs and disparities
While colorectal cancer screening has increased in recent years, access and participation are not evenly distributed across communities. In Minnesota, the overall screening rate is 69.7%, but this statewide average masks significant disparities. Screening participation is substantially lower in some populations, including communities where Somali, Hmong, and Spanish are primary languages. In these groups, screening rates can fall to approximately 32% among Somali speakers, 47% among Hmong speakers, and 48% among Spanish-speaking populations, highlighting persistent gaps in prevention and early detection.
Disparities are also evident across racial and ethnic groups. Screening rates are lower among Black Minnesotans (58.5%) and American Indian/Alaska Native populations (51.8%) compared to the state average, reflecting broader inequities in access to care and preventive services.
These patterns reflect a combination of structural, cultural, and access-related barriers that influence how and whether individuals engage with screening. Data here are drawn from Minnesota Community Measurement and the Masonic Cancer Center Catchment Analysis.
To better understand the barriers contributing to these disparities, our Community Outreach and Engagement team conducted a community needs assessment. Surveys and conversations with community members revealed several common challenges. Many participants reported fear or anxiety about colorectal cancer screening, discomfort with screening procedures, and limited knowledge about colorectal cancer and the importance of screening and early detection. Others described financial concerns, transportation barriers, and difficulty scheduling appointments or accessing clinics.
These insights underscored the importance of designing screening initiatives that address real-world obstacles. Rather than relying solely on traditional clinic-based models, our Community Outreach and Engagement team used these findings to shape a screening program grounded in community output, accessibility, trust, and support.
The model: A community-informed mobile screening approach
In response to these gaps, the University of Minnesota developed a community-informed screening initiative through the Mobile Colorectal Cancer Community Screening Program, a collaboration between the Masonic Cancer Center (MCC) and the University’s Mobile Health Initiative (MHI). The program brings colorectal cancer screening directly into community settings, combining prevention education, accessible testing options, and personalized support to help individuals navigate the screening process.
A central component of the model is partnership with trusted community organizations. Early collaboration with groups such as the Power of People Leadership Institute (POPLI) and the Islamic Association of North America (IANA) helped guide outreach strategies and shape culturally relevant education about colorectal cancer. These partnerships allow the program to meet people in familiar community spaces while building trust and encouraging open conversations about prevention and early detection.
The program also emphasizes a navigation-centered approach to screening. A community health worker and nurse navigator provide individualized guidance throughout the process, from education and enrollment to follow-up care, helping participants understand their screening options and address logistical challenges such as scheduling, language access, or transportation.
To reduce barriers to participation, the program incorporates low-barrier screening options. Many participants begin with stool-based screening tests that can be completed at home, allowing individuals to participate without needing an immediate colonoscopy appointment. Through a partnership with Exact Sciences, the program is also able to provide free stool-based test kits to uninsured participants, further increasing access to screening. Navigation support, reminders, and follow-up help ensure that participants complete testing and receive appropriate next steps if results require further evaluation.
To support participants who need additional testing after a positive stool-based result, the program partnered with MNGI Digestive Health to provide no-cost follow-up colonoscopy for uninsured and underinsured individuals. This reduces financial barriers while ensuring participants can access necessary care. Together, these elements create a screening model designed to be both accessible and responsive to community needs.
Initial outcomes and insights
Early results from the pilot phase of the program demonstrate both feasibility and strong community engagement. To date, the initiative has conducted 78 screening consultations across 17 community events, with 37 individuals enrolled in stool-based screening. Of those, 23 screening kits have been completed and returned, resulting in a 62.2% return rate, on the higher end for harder to screen, underserved populations, when compared to national adherence averages for similar programs. These early outcomes reflect meaningful participation, particularly given the program’s focus on communities that have historically faced barriers to screening as well as the effectiveness of its navigation system.
Beyond hard numbers, participant feedback has been overwhelmingly positive. Among participants who completed an end survey, 100% reported they would participate in the program again and 94.7% would recommend it to others! Participants also shared that the program helped reduce several common barriers to screening, including fear and anxiety, concerns about discomfort, challenges with scheduling and finding time, transportation and clinic access issues, and the cost of care. Together, this feedback shows the program is building trust while addressing real barriers to screening.
Interest in the program continues to grow, with increasing engagement from community partners and participation at local events. While still early, these results suggest that meeting people where they are, both geographically and culturally, can meaningfully improve engagement with colorectal cancer screening.
Why this model matters
This approach reflects a broader shift in how preventive care can be delivered, moving beyond traditional, clinic-based models toward strategies that are more responsive to the realities of people’s lives. By embedding screening within trusted community spaces and pairing it with personalized navigation, the program addresses not only access, but the factors that influence whether individuals engage with care in the first place.
“This model reflects what MCC, MHI, and our partners are all about: making a tangible impact in the lives of Minnesotans through collaboration and innovation,” said Amna Hussein, MBS, Community Outreach and Engagement Manager at the Masonic Cancer Center. “From the beginning, this work has shown what’s possible when you build with community and center trust, access, and partnership. By bringing screening beyond traditional clinical settings and into the community, we are not only expanding access to life-saving screening, but also helping close long-standing gaps in prevention and early detection.”
Early insights from the program highlight the importance of consistency, trust, and sustained community presence. Rather than one-time outreach, meaningful engagement requires ongoing relationships and the ability to adapt based on community feedback.
While still evolving, this model offers a framework that could inform similar efforts to improve screening access and reduce disparities in other settings, particularly where traditional approaches have fallen short.
The path forward
Colorectal cancer remains one of the most preventable cancers when screening is accessible, timely, and widely adopted. Yet, as this work highlights, improving outcomes requires more than awareness; it demands innovative community-based strategies grounded in the realities of the communities served.
By combining community partnership, accessible screening options, and coordinated support, this model demonstrates how prevention efforts can become more responsive, inclusive, and effective. Meeting individuals where they are, both geographically and culturally, has the potential to close persistent gaps in screening and early detection.
As Colorectal Cancer Awareness Month comes to an end, initiatives like this underscore what is possible when research, clinical care, and community engagement come together to expand access and improve health outcomes across Minnesota and beyond.
To learn more or get involved, contact: [email protected]