Patient Perception and Cost-Effectiveness of a Patient Navigation Program to Improve Breast Cancer Screening for Hispanic Women

Abstract

Purpose: Hispanic women are less likely to be screened for breast cancer than non-Hispanic women, which contributes to the disproportionate prevalence of advanced-stage breast cancer in this population group. Patient navigation may be a promising approach to help women overcome the complexity of accessing multiple health care services related to breast cancer screening and treatment. The goal of this study is to assess patient perception and cost-effectiveness of a multilevel, community-based patient navigation program to improve breast cancer screening among Hispanic women in South Texas. Methods: We used mixed methods—including focus groups of program participants and a microsimulation model of breast cancer—to evaluate the effectiveness and cost-effectiveness of the program on the target population. Program data from 2013 to 2016 were collected and used to conduct the analyses. Results: Focus groups showed that the patient navigation program improved patient knowledge, attitudes, and behaviors regarding breast health and increased the mammography screening rate from 60% to 80%. Cost-effectiveness analysis showed that the program could increase life expectancy by 0.71 years and yield an incremental cost-effectiveness ratio of $3120 per quality-adjusted life year compared to no intervention. Conclusion: The 3-year multilevel, community-based patient navigation program effectively increased mammography screening uptake and adherence and improved knowledge and behaviors on breast health among program participants. Future research is needed to translate and disseminate the program to other socioeconomic and demographic groups to test its robustness and design.

SMYD2 promotes cervical cancer growth by stimulating cell proliferation

“…Additionally, early cervical cancer has no obvious symptoms, which therefore increases the difficulty of diagnosis [7]. In order to combat this disease, not only improved early diagnosis is requirement, novel and promising therapeutic targets are also urgly needed [8].…”

The Case for Patient Navigation in Lung Cancer Screening in Vulnerable Populations: A Systematic Review

“…60,61 A cervical cancer screening patient navigation program tailored to vulnerable populations found navigation to be cost-effective compared to usual care. 62 A capitated payment lung cancer treatment patient navigation program for Medicare patients was cost-effective with an incremental cost-effectiveness ratio of $19,312 per quality-adjusted life year. 63 A patient navigation program at Henrico Doctors' Hospital found a navigation model assigning breast cancer patients to a navigator at time of suspicious finding through 12-months post diagnosis was effective in increasing revenue, standardizing care, and increasing patient retention throughout the care continuum.…”

The Growing Importance of Cancer Care Navigation

“…37,38,39 Additionally, studies that have considered the specific cost effectiveness or cost savings associated with navigation services show positive trends. 40,41,42 Results from a cost-effectiveness (CE) analysis of the Chicago Cancer Navigation Project (CCNP), 43 a CE study of a navigation program to improve cervical cancer screening among Hispanic women in San Antonio, Texas, 44 and a CE analysis of a capitated navigation program for Medicare beneficiaries with lung cancer 45 all supported the cost effectiveness of navigation programs in breast, cervical, and lung cancer, respectively. Other health care cost analyses performed on government funded navigation programs such as the Center for Medicare & Medicaid Innovation (CMMI)-funded Health Care Innovation Awards (HCIA), 46 and the National Cancer Institute (NCI) Patient Navigation Research Program (PNRP) 47 have also shown promising trends in the impact of navigation services.…”