Study: Patient navigation increases cancer screening rates for high-risk patients

A study, published by JAMA Internal Medicine, has found that patient navigation as part of a population-based IT system is able to greatly increase screening rates for breast, cervical, and colorectal cancer in patients at high risk for nonadherence with testing.

With the many advances in screening and technology we have today, patient navigation (PN) is something that should be readily available to healthcare patients but the reality is that it’s far from that reality. Rates of cancer morbidity and mortality are still high, especially for low-income patients and racial/ethnic minorities.

“The objective of our study was to evaluate the impact of population-based, IT-enabled PN for comprehensive breast, cervical, and/or CRC screening in low-income and racial/ethnic minority patients receiving care in a primary care network,” wrote Sanja Percac-Lima, MD, PhD, and colleagues.

Patient navigators are guides for patients through the sometimes messy and confusing healthcare space they find themselves in. Being able to access their own care is crucial for patients to overcome identified individual barriers.

The study developed a PN program in a community health center that was further expanded to enable navigation of patients at high risk for screening nonadherence in all practices. Researchers conducted the trial from April 2014 to December 2014 in 18 practices in an academic primary care network.

In terms of an as-treated analysis, the mean cancer-screening completion rates were 5.9 percent higher in the intervention group for all cancers. Broken down by category, the cancer-screening completion rates were higher by 7.1 percent for breast, 7.9 percent higher for cervical and 5.0 percent higher for colorectal cancers.

One of the highlighted factors of importance in this study was identifying patients who could most benefit from PN, those at high risk of being lost to follow-up. The identification of these patients is crucial when implementing PN programs from a cost-effectiveness perspective. In the authors primary care network, almost 14,000 patients were overdue for at least 1 cancer screening.

“We developed an algorithm that enabled us to choose about 11% of patients at high-risk for nonadherence with screening. In our randomized clinical trial, we showed that these patients were unlikely to get screened without PN,” wrote Percac-Lima and colleagues. “Future studies should explore the cost-effectiveness and patient satisfaction with personalized patient-centered cancer screening PN programs.”