Patient navigation benefits timely cancer diagnosis, care for vulnerable patients

(Press-News.org) (Boston) – Researchers at Boston Medical Center (BMC) have shown that patient navigation services help decrease the time to diagnosis for female patients who have received an abnormal result from a breast or cervical cancer screening. The study demonstrates the importance of patient navigation in helping vulnerable populations get the care that they need in a timely manner and supports the recent standard recommendations for all cancer care centers to provide patient navigation services.

Tracy Battaglia, MD, MPH, director of the Women's Health Unit at BMC and associate professor of medicine at Boston University School of Medicine (BUSM), is the study's lead author. The study is published in the journal Cancer Epidemiology, Biomarkers & Prevention as part of a special focus on patient navigation in cancer care.

The Boston Patient Navigation Research Program, which was conducted at six federally qualified inner-city community health centers affiliated with BMC between 2004 and 2008, is part of a five-year national study designed to reduce delays in completing recommended care after an abnormal cancer screening. During the intervention, 1,497 female subjects received patient navigation services and 1,544 were in the control group. All subjects were followed for one year to document whether all recommended tests were completed and women received a final diagnosis of cancer or no cancer.

The subjects who received navigation services were diagnosed in significantly less time and were more likely to ever complete their care compared to the control subjects. The decrease in time was shown among all women who received abnormal cervical screening results and among the subset of women with abnormal breast cancer screening results who took longer than 60 days to complete their care.

Data shows that low-income racial/ethnic minority patients often do not access timely, quality cancer treatment and services. "The goal of patient navigation is to facilitate timely care for these vulnerable patients by addressing barriers to care," said Battaglia. Patient navigation services include identifying patients at risk for delays in treatment and facilitating appointment scheduling by identifying and addressing barriers that may interfere with this care, such as: child care and transportation services; coordinating care among numerous providers; organizing interpreter services; and providing guidance and support so patients can advocate for themselves.

According to the Centers for Disease Control and Prevention (CDC), breast cancer is the most common cancer among women in the United States aside from non-melanoma skin cancer and is one of the leading causes of cancer death among women of all races and Hispanic origin populations. The CDC also notes that more black and Hispanic women get HPV-associated cervical cancer than women of other races or ethnicities, which is possibly due to a decreased access to Pap testing or follow-up treatment.

"This study confirms the long presumed benefit of navigation for vulnerable populations and supports recent standard recommendations for all cancer centers to provide patient navigation services to their patients, especially those whose patients are at risk for delays in care," said Battaglia.

### Future studies will examine which components of navigation are most critical to their success.

Research reported in this published article was supported by the NCI and the Center to Reduce Cancer Health Disparities under award number U01 629 CA116892-01 (Principal Investigator: Freund).