Patient navigation to increase colorectal cancer screening among Latino Medicare enrollees: a randomized controlled trial

Enard, Kimberly R.; Nevarez, Lucinda; Hernandez, Mike; Hovick, Shelly R.; Moguel, M.R.; Hajek, Richard A.; Blinka, Caren E.; Jones, Lovell A.; Torres-Vigil, Isabel

doi:10.1007/s10552-015-0620-6

Cited by 38 publications

(79 citation statements)

References 32 publications

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“…The majority of these studies tested the impact of PN on screening rates for colorectal (n = 32 [67%]), breast (n = 13 [27%]), or cervical cancer (n = 4 [8%]) . Thirty‐nine articles reported a significant favorable increase in cancer screening rates for PN intervention groups versus controls . Thirteen studies (27%) targeted African American, Latino, Korean American, Asian/Pacific Islander, and non–US‐born urban minority populations .…”

Section: Resultsmentioning

confidence: 99%

The efficacy and cost‐effectiveness of patient navigation programs across the cancer continuum: A systematic review

Bernardo

Zhang

Hery

et al. 2019

Cancer

133

166

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Published studies regarding patient navigation (PN) and cancer were reviewed to assess quality, determine gaps, and identify avenues for future research. The PubMed and EMBASE databases were searched for studies investigating the efficacy and cost‐effectiveness of PN across the cancer continuum. Each included article was scored independently by 2 separate reviewers with the Quality Assessment Tool for Quantitative Studies. The current review identified 113 published articles that assessed PN and cancer care, between August 1, 2010, and February 1, 2018, 14 of which reported on the cost‐effectiveness of PN programs. Most publications focused on the effectiveness of PN in screening (50%) and diagnosis (27%) along the continuum of cancer care. Many described the effectiveness of PN for breast cancer (52%) or colorectal cancer outcomes (51%). Most studies reported favorable outcomes for PN programs, including increased uptake of and adherence to cancer screenings, timely diagnostic resolution and follow‐up, higher completion rates for cancer therapy, and higher rates of attending medical appointments. Cost‐effectiveness studies showed that PN programs yielded financial benefits. Quality assessment showed that 75 of the 113 included articles (65%) had 2 or more weak components. In conclusion, this review indicates numerous gaps within the PN and cancer literature where improvement is needed. For example, more research is needed at other points along the continuum of cancer care outside of screening and diagnosis. In addition, future research into the effectiveness of PN for understudied cancers outside of breast and colorectal cancer is necessary along with an assessment of cost‐effectiveness and more rigorous reporting of study designs and results in published articles.

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Section: Resultsmentioning

confidence: 99%

The efficacy and cost‐effectiveness of patient navigation programs across the cancer continuum: A systematic review

Bernardo

Zhang

Hery

et al. 2019

Cancer

133

166

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“…The disparate rates of decline in CRC incidence among older individuals of different racial/ethnic groups may reflect either divergent rates of polyp incidence due to shifts in culturally-dependent CRC risk factors or simply the well-documented lower CRC screening rates among minority populations 18 . The decline in CRC incidence among older AAs may be “catching-up” to that in NHWs due to heightened awareness of the elevated CRC risk in AAs and improved compliance with CRC screening recommendations, whereas the slower rate of decline among older Hispanics may result from slower adoption of CRC screening in this ethnic group 19,20 . Despite the absence of a statistically significant decline in CRC incidence among Hispanics ≥50 over the entire study period, the suggestion that CRC incidence may have reached its peak in 2000 and started to decline thereafter (see Figure 1c) may reflect a rising frequency of CRC screening among older Hispanics.…”

Section: Discussionmentioning

confidence: 99%

Rising Incidence of Colorectal Cancer Among Young Hispanics in Texas

Wang

Thrift²,

Zarrin-Khameh³

et al. 2017

Journal of Clinical Gastroenterology

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Goals To investigate trends in colorectal cancer (CRC) incidence and survival among Hispanics in Texas. Background The incidence of CRC is rising among young adults in the US. Given Texas’ large Hispanic population, investigating CRC trends in Texas may provide valuable insight into the future of CRC epidemiology in an ever-diversifying US population. Study Data from the Texas Cancer Registry (1995–2010) were used to calculate age-adjusted CRC rates based on the 2000 US standard population. Annual percentage change (APC) and five-year cancer-specific survival (CSS) rates were reported by age, race/ethnicity, stage, and anatomical location. Results Of 123,083 CRC cases, 11% occurred in individuals <50 years old, 26% of whom were Hispanic. Incidence was highest among African Americans (AAs; 76.3/100,000), followed by non-Hispanic whites (NHWs; 60.2/100,000) and Hispanics (50.8/100,000). Although overall CRC incidence declined between 1995 and 2010 (APC −1.8%, p<0.01), trends differed by age and race/ethnicity. Among individuals ≥50, the rate of decline was statistically significant among NHWs (APC −2.4%, p<0.01) and AAs (APC −1.3%, p<0.01) but not among Hispanics (APC −0.6%, p=0.13). In persons aged 20–39, CRC incidence rose significantly among Hispanics (APC 2.6%, p<.01) and NHWs (APC 2.4%, p<0.01), but not AAs (APC 0.3%, p =0.75). CSS rates among Hispanics and NHWs were comparable across most age groups and cancer stages whereas CSS rates among AAs were generally inferior to those observed among NHWs and Hispanics. Conclusion Although CRC incidence has declined in Texas, it is rising among young Hispanics and NHWs while declining more slowly among older Hispanics than among older NHWs and AAs.

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“…RCTs have shown that patient navigation is an effective intervention for implementing stool‐based and colonoscopy‐based screening programs. Navigation is particularly helpful in increasing CRC screening in vulnerable populations . Investigators have offered helpful guidance on key considerations when designing a successful navigation program .…”

Section: Options For Crc Screeningmentioning

confidence: 99%

“…Investigators have offered helpful guidance on key considerations when designing a successful navigation program . Tailored patient navigation that allows the patient's care team to address specific patient barriers to screening, including language, has been shown to be more effective than standard navigation . Personal invitation letters, preferably signed by the care provider, and reminders mailed to all nonattendees are also highly effective in enhancing CRC screening acceptance …”

Section: Options For Crc Screeningmentioning

confidence: 99%

Colorectal cancer screening for average‐risk adults: 2018 guideline update from the American Cancer Society

Wolf

Fontham

Church

et al. 2018

CA A Cancer J Clinicians

1,430

1,108

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In the United States, colorectal cancer (CRC) is the fourth most common cancer diagnosed among adults and the second leading cause of death from cancer. For this guideline update, the American Cancer Society (ACS) used an existing systematic evidence review of the CRC screening literature and microsimulation modeling analyses, including a new evaluation of the age to begin screening by race and sex and additional modeling that incorporates changes in US CRC incidence. Screening with any one of multiple options is associated with a significant reduction in CRC incidence through the detection and removal of adenomatous polyps and other precancerous lesions and with a reduction in mortality through incidence reduction and early detection of CRC. Results from modeling analyses identified efficient and model-recommendable strategies that started screening at age 45 years. The ACS Guideline Development Group applied the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria in developing and rating the recommendations. The ACS recommends that adults aged 45 years and older with an average risk of CRC undergo regular screening with either a high-sensitivity stool-based test or a structural (visual) examination, depending on patient preference and test availability. As a part of the screening process, all positive results on noncolonoscopy screening tests should be followed up with timely colonoscopy. The recommendation to begin screening at age 45 years is a qualified recommendation. The recommendation for regular screening in adults aged 50 years and older is a strong recommendation. The ACS recommends (qualified recommendations) that: 1) average-risk adults in good health with a life expectancy of more than 10 years continue CRC screening through the age of 75 years; 2) clinicians individualize CRC screening decisions for individuals aged 76 through 85 years based on patient preferences, life expectancy, health status, and prior screening history; and 3) clinicians discourage individuals older than 85 years from continuing CRC screening. The options for CRC screening are: fecal immunochemical test annually; high-sensitivity, guaiac-based fecal occult blood test annually; multitarget stool DNA test every 3 years; colonoscopy every 10 years; computed tomography colonography every 5 years; and flexible sigmoidoscopy every 5 years. CA Cancer J Clin 2018;68:250-281. © 2018 American Cancer Society.

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Patient navigation to increase colorectal cancer screening among Latino Medicare enrollees: a randomized controlled trial

Cited by 38 publications

References 32 publications

The efficacy and cost‐effectiveness of patient navigation programs across the cancer continuum: A systematic review

The efficacy and cost‐effectiveness of patient navigation programs across the cancer continuum: A systematic review

Rising Incidence of Colorectal Cancer Among Young Hispanics in Texas

Colorectal cancer screening for average‐risk adults: 2018 guideline update from the American Cancer Society

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