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Making Cancer Part of the Conversation

October 01, 2019

Jose DeJesus was born and raised in New Haven, but that’s not why the Community Health Educator for Yale Cancer Center and Smilow Cancer Hospital is such a familiar face around town. “When I walk into stores, people say, ‘Hey! It’s the cancer guy!’” explained Mr. DeJesus. For the past four years, he has been spreading the word out to Connecticut residents about the need for cancer screening and prevention, and his message—that healthy people over 40 need to be screened for common cancers—is getting through. “They’ll come over and ask questions about when and where the next free screenings will be held,” said Mr. DeJesus. “That’s what I’m most proud of—that we’ve become a resource for the community, and beyond.”

It wasn’t always that way. According to Mr. DeJesus, things were more difficult back in 2016, when it was just him and his supervisor, Beth Jones, PhD, MPH, Director of the Smilow Screening & Prevention Program. “When you say the word ‘cancer,’ people get scared,” said Mr. DeJesus. “At first, I had to pound the pavement asking various agencies and community organizations if they were interested in having us make presentations about screening and prevention. Now, we have repeat customers. Even better, people are not just going to our free screenings once and disappearing, but they are getting screenings done at the proper intervals.”

That progress, in part, stems from Mr. DeJesus’s natural enthusiasm—he is a man on a mission, determined to target people who might not otherwise think about getting mammograms or skin checks on a regular basis. He understands the obstacles that some of Connecticut’s neediest residents face, from homelessness to food insecurity to addiction issues. “If I was a homeless person, I wouldn’t want to bother with screenings either. But you have to be respectful, and to meet people where they are.”

Besides mammography, Mr. DeJesus and the community outreach team— which is now seven people strong—offers talks and free screenings for lung, prostate, colorectal, breast, cervical, skin, and head and neck cancers. “All the departments [at Yale] are working together to help reduce disparities in cancer outcomes among different populations across the state,” said Mr. DeJesus. “If we do our job right, then everyone will be screened, and if they have cancer, we’ll catch it early when it can be cured.”

Mr. DeJesus and the screening team are well on their way to that goal. In 2016, the program’s first year, they sponsored 24 community outreach events in Connecticut that reached 2,205 people. In 2019, there were over 100 community outreach and education events that reached 6,543 individuals, whether in Torrington, where Mr. DeJesus brings a pair of giant inflatable lungs to presentations to help combat higher rates of smoking and lung cancer; or in Hartford, where they target the large Latino population for prostate cancer screenings. “The rate of prostate cancer is five times higher in Latino men,” said Mr. DeJesus. All told, the program has delivered small group education sessions or free screenings to a whopping 18,467 people, quadruple the number in 2016. There’s a real need for this kind of ‘boots on the ground outreach,’ as Mr. DeJesus calls it. “Connecticut is in the highest quintile for cancer in the United States—particularly breast cancer and prostate cancer,” said Dr. Jones. She also points to the state’s history of ‘residential segregation,’ in which poorer residents who are less likely to be screened tend to be concentrated in urban areas. “That’s why we are reaching beyond New Haven to focus on other urban pockets across the state.”

Along with that, the team is considering various social and economic factors that might make it difficult for people to get to the doctor and enrolling vulnerable residents in its new health navigation program, which goes beyond screenings to try to address problems like housing insecurity, addiction issues, mental health problems, and more. “It’s one thing to go into the community and give people information, but we are also taking the extra step to help people get tobacco treatment, or steer them to places where they can exercise, or access healthier food,” said Dr. Jones.

Sometimes, the obstacles to health can be more basic, like difficulty scheduling a screening appointment. “Often, people don’t know who to call to get a colonoscopy, or they give up when no one calls back,” explained Monique Stefanou, a Community Health Educator and the team’s lead Health Navigator. “I answer calls from our information line and set up appointments,” she said. “One woman went to our skin cancer screening in Trumbull, and the doctor found something that had to be removed. Later, she called, and said, ‘Do you have any other screenings coming up?’ I love getting people connected to care.”

Another new initiative: Starting in 2020, the team will be providing FIT kits to Connecticut residents to encourage them to do a self-screening for colorectal cancer, which is on the rise, particularly among younger people. The at-home tests detect whether blood is present in stool. “We’ll do follow up calls, and if someone’s test comes back positive, they’ll move to the front of the line for a colonoscopy,” said Mr. DeJesus.

Some people might be squeamish talking to strangers about colon cancer or stool tests. But Mr. DeJesus relishes the challenge. “I love my job—in fact, I don’t even consider it a job. I’m not selling anything. I just want to give out information on screenings, and help people to those appointments. I tell my boss all the time—it feels amazing.”

Submitted by Emily Montemerlo on September 15, 2020