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09-06-2011 | Surgery | Article

Patient navigators improve CRC screening rates among racial minorities


Free abstract

MedWire News: Study findings suggest patient navigators can improve colorectal cancer (CRC) screening rates among low-income patients who are Black, or whose primary language is not English.

The findings are of importance, given that CRC is one of the leading causes of cancer deaths. Karen Lasser (Boston University, Massachusetts, USA) and co-authors say that, "approximately 40% of eligible adults in the United States and more foreign-born US residents are overdue for CRC screening," especially racial minorities, immigrants, socioeconomically disadvantaged individuals, and those who have Medicaid or lack health insurance.

The researchers randomly assigned 465 patients enrolled in the public health system who were not up-to-date with CRC screening and spoke a primary language other than English to receive a patient navigation-based intervention or usual care. Individuals in the intervention group received an introductory letter from their primary care provider with educational material, followed by telephone calls from a navigator who spoke their primary language. Patients were offered the option of screening by fecal occult blood testing or colonoscopy.

During the 1-year study period, significantly more patients assigned to the intervention group underwent CRC screening compared with those assigned to usual care, at 33.6% versus 20.0%, respectively.

Furthermore, the screening rate was significantly higher among patients who the navigators were able to reach (39.8%) compared with those who could not be contacted (18.6%).

Compared with those receiving usual care, patients assigned to the intervention group were also significantly more likely to be screened with colonoscopy (13.0 vs 26.4%, respectively).

Further analyses revealed that the intervention was particularly beneficial for patients aged over 60 years, those whose primary language was not English, and for Black individuals, as shown by significantly higher rates of CRC screening in the intervention group compared with the usual care group (40.0 vs 17.7%, 39.8 vs 18.6%, and 39.7 vs 16.7%, respectively).

"Focusing patient navigation on populations of patients who are Black and whose primary language is other than English may be a particularly effective approach to reducing CRC screening disparities for these patients," conclude the authors in the Archives of Internal Medicine.

They add: "Future research should assess how healthcare systems can sustain this benefit when patient navigation is implemented as a routine component of primary care."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Ingrid Grasmo

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