Patient navigators could help improve comprehensive cancer screening rates among low-income, ethnic minorities

A clinical trial conducted by Massachusetts General Hospital (MGH) investigators has found that the use of patient navigators - individuals who assist patients in receiving health care services - may improve comprehensive cancer screening rates among patient populations not likely to receive recommended screenings. The study, which received Online First publication earlier this month in JAMA Internal Medicine, found that such patients - mostly low-income and ethnic minorities - were more likely to adhere to cancer-screening guidelines when assisted by patient navigators.

"These findings demonstrate how effective patient navigators can be for patients who, for a variety of reasons, encounter obstacles to receiving cancer screening," says Sanja Percac-Lima, MD, PhD, physician leader for cancer outreach at the MGH Center for Community Health Improvement and the study's lead author. "Health disparities pose a major challenge to low-income and ethnic minority patients, and our study suggests a proactive approach may help increase their chances of receiving the care they need."

Using a computer system, researchers identified patients across 18 MGH primary care practices, including four community health centers, who were at-risk of not completing recommended cancer screenings - based on a previous missed appointment and their primary language not being English - and who were also overdue for breast, cervical, and/or colorectal cancer screening. Among 1,626 identified at-risk patients, 792 were randomly assigned a patient navigator who would provide intense outreach and guidance to assist in obtaining screenings. Navigators contacted patients in their own language, educated and encouraged them, arranged transportation and accompanied them to visits, and helped overcome any other barriers to obtaining screening. The study results showed that 32 percent of patients who were successfully connected with patient navigators completed at least one overdue cancer screening, compared with 18 percent of patients in the control group.

"Patient navigators provide a critical bridge between patients and caregivers that enhances and improves care," says Percac-Lima, who is an assistant professor of Medicine at Harvard Medical School. "By employing these types of tactics, we can address critical health disparities for at-risk communities."