Low-income minorities are more likely to get screened for colon cancer if they're paired with a patient navigator, according to a study published in the March 2008 issue of the Journal of the National Medical Association.
A patient navigator is a person who can help facilitate the process of scheduling a colonoscopy and answering questions about the procedure. Patient navigators are trained health educators who serve as patient-care liaisons.
"Generally, poorer minorities have a high cancer burden mainly due to low cancer screening rates," says Dr. Jennifer Christie, MD, study lead investigator and assistant professor of gastroenterology at the Emory University School of Medicine. "Patient navigation is an effective intervention to increase colon cancer screening rates and decrease colon cancer mortality."
Dr. Christie tracked 21 men and women, all over the age of 50, who were referred by their primary care physician for a screening colonoscopy. Most were uninsured or had public insurance. Thirteen patients were assigned patient navigators (PNs); the other eight patients did not receive a PN.
More than half of the patients with patient navigators heeded their physician's referral and received a colonoscopy screening compared to just 13 percent of non-PN patients.
"Navigating the healthcare system can be very difficult particularly for low-income patients due to economic, organizational, cultural and language barriers," Dr. Christie says. "A patient navigator program can help to streamline the cancer screening process as well as help underrepresented minorities feel more comfortable with the screening procedure."
Though the benefits of early detection in preventing colorectal cancer deaths are well known - a 90 percent or higher cure rate when found early - an estimated 41.8 million Americans age 50 and older at average risk for colon cancer haven't been screened according to national guidelines, a recent study by the Centers for Disease Control and Prevention (CDC) found. This is particularly true among minority populations, who often face unique barriers to health care, Dr. Christie says.
In this clinical trial, PNs helped patients schedule their colonoscopy appointments, answered questions patients had about colonoscopies, helped to ease patients' fears and anxieties about the procedure, assisted patients with transportation to and from their appointments, and even followed up with a phone call after patients underwent screenings. Services were offered for both English and Spanish-speaking patients.
The pilot study is the first randomized trial to evaluate the effectiveness of patient navigators in increasing colonoscopy-screening rates among low-income minorities. The results are promising, but more research is needed, notes Dr. Christie. Future investigations will examine the particular aspects of patient navigation deemed most effective.
The study, "A Randomized Controlled Trial Using Patient Navigation to Increase Colonoscopy Screening among Low-Income Minorities," was conducted in collaboration with researchers at New York's Mount Sinai School of Medicine. The National Cancer Institute supported the research.
For more information on colorectal cancer screening, visit Emory's CancerQuest web site at , or call Emory Healthcare's HealthConnection at 404-778-7777 or visit the Emory Healthcare web site.