Personal Navigation Increases Colorectal Cancer Screening Uptake

Ritvo, Paul; Myers, Ronald E.; Paszat, Lawrence; Tinmouth, Jill; McColeman, Joshua; Mitchell, Brian; Serenity, Mardie; Rabeneck, Linda

doi:10.1158/1055-9965.epi-14-0744

Cited by 52 publications

(33 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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%

“…10, Thirty-nine articles reported a significant favorable increase in cancer screening rates for PN intervention groups versus controls. 10,[32][33][34][35][37][38][39][41][42][43][44][45][47][48][49][50][51][52][53][54][55][56][58][59][60][61][62][64][65][66]69,[71][72][73][74][75][76]78 Thirteen studies (27%) targeted African American, Latino, Korean American, Asian/Pacific Islander, and non-US-born urban minority populations. 42,47,49,50,52,57,58,65,71,72,…”

Section: Screeningmentioning

confidence: 99%

See 1 more Smart Citation

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

Bernardo

Zhang

Hery

et al. 2019

Cancer

134

166

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Screeningmentioning

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

134

166

View full text Add to dashboard Cite

show abstract

“…The potential fear of what is involved and a poor understanding of the rationale and potential benefits and harms of cervical screening could be addressed by use of a nurse navigator (NN), a term coined in the USA, where this role has been evaluated in a number of areas of health. 10 Finally, we considered that offering a choice between two different interventions, NNs and timed appointments would be attractive to some women who might wish to exert a preference.…”

Section: Considerations In Designing a Study To Address Non-participamentioning

confidence: 99%

A cluster randomised trial of strategies to increase cervical screening uptake at first invitation (STRATEGIC)

Kitchener

Gittins

Rivero‐Arias

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

BackgroundFalling participation by young women in cervical screening has been observed at a time that has seen an increase in the incidence of cervical cancer in the UK in women aged < 35 years. Various barriers to screening have been documented, including fear, embarrassment and inconvenience.ObjectivesTo measure the feasibility, clinical effectiveness and cost-effectiveness of a range of interventions to increase the uptake of cervical screening among young women.DesignA cluster randomised trial based on general practices performed in two phases.SettingPrimary care in Greater Manchester and the Grampian region in Scotland.ParticipantsPhase 1: 20,879 women receiving their first invitation for cervical screening. Phase 2: 10,126 women who had not attended by 6 months.InterventionsPhase 1: pre-invitation leaflet or not, and access to online booking (Manchester only). Phase 2: (1) vaginal self-sampling kits (SSKs) sent unrequested (n = 1141); or (2) offered on request (n = 1290); (3) provided with a timed appointment (n = 1629); (4) offered access to a nurse navigator (NN) (n = 1007); or (5) offered a choice between a NN or a SSK (n = 1277); and 3782 women in control practices.Main outcome measuresUplift in screening compared with control practices, cost-effectiveness of interventions, and the women’s preferences explored in a discrete choice experiment.ResultsThe pre-invitation leaflet and offer of online booking were ineffective when compared with control practices at 3 months, 18.8% versus 19.2% [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.88 to 1.06;p = 0.485] and 17.8% versus 17.2% (OR 1.02, 95% CI 0.87 to 1.20;p = 0.802), respectively. The uptake of screening at 3 months was higher among previously human papillomavirus (HPV)-vaccinated women than unvaccinated women, 23.7% versus 11% (OR 2.07, 95% CI 1.69 to 2.53;p < 0.001). Among non-attenders, the SSK sent intervention showed a statistically significant increase in uptake at 12 months post invitation, 21.3% versus 16.2% (OR 1.51, 95% CI 1.20 to 1.91;p = 0.001), as did timed appointments, 19.8% versus 16.2% (OR 1.41, 95% CI 1.14 to 1.74;p = 0.001). The offer of a NN, a SSK on request, and a choice between timed appointments and NN were ineffective. Overall, there was a gradual rather than prompt response, as demonstrated by uptake among control practices. A discrete choice experiment indicated that women invited who had not yet attended valued the attributes inherent in self-sampling. The health economic analysis showed that both timed appointments and unsolicited SSK sent were likely to be cost-effective at a cost per quality-adjusted life-year (QALY) gained of £7593 and £8434, respectively, if extended across the national 25-year-old cohort throughout the duration of screening. The certainty of these being cost-effective at a ceiling ratio of £20,000 per QALY gained was > 90%.ConclusionWomen receiving their initial screening invitation frequently delay taking up the offer and the net impact of interventions was small. Timed appointments and SSKs sent to non-attenders at 6 months are likely to be a cost-effective means of increasing uptake and should be considered further. HPV vaccination in the catch-up programme was associated with an increased uptake of cervical screening. Future work should focus on optimising self-sampling in terms of age range, timing of offer for non-attenders and use of urine testing instead of vaginal samples.Trial registrationCurrent Controlled Trials ISRCTN52303479.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 68. See the NIHR Journals Library website for further project information.

show abstract

“…Studies demonstrating marked, statistically significant differences between groups tend to be those that compare intervention versus "usual care" or no intervention. [39][40][41][42] It is important to note that addressing the barrier of access to screening by providing a free FIT kit may have been more important than the independent influence of culturally targeting the educational materials. In both arms, the FIT kits played an important role in screening completion.…”

Section: Community Crc Screening Trial/christy Et Almentioning

confidence: 99%

A community‐based trial of educational interventions with fecal immunochemical tests for colorectal cancer screening uptake among blacks in community settings

Christy

Davis

Williams

et al. 2016

Cancer

View full text Add to dashboard Cite

Background Intervention studies among individuals in diverse community settings are needed to reduce health disparities in colorectal cancer (CRC) screening and mortality rates. The current study compared the efficacy of two intervention conditions promoting CRC screening among Black individuals. Methods Black individuals (aged 50-75, N=330) were recruited in community settings in four Tampa Bay counties. Following consent and a baseline interview which assessed sociodemographic and health-related variables, participants received a culturally-targeted CRC photonovella booklet plus fecal immunochemical test (FIT) kit or a standard CRC screening brochure plus FIT kit. The primary outcome was FIT kit screening uptake. Results FIT screening uptake at 6 months was 86.7% overall (90.3% in the brochure group and 81.9% in the photonovella group). Controlling for baseline between group differences, there was no influence of intervention on FIT kit uptake (p=.756). Significant predictors of not returning a FIT kit included being unable to work (p=.010), having higher religious belief scores (p=.015), and living further from the cancer center (p=.015). Conclusions Providing FIT kits and educational print materials to Black individuals in community settings resulted in high rates of CRC screening. The study also identified subgroups of participants who were less likely to return a FIT kit and provides insight for future interventions.

show abstract

Personal Navigation Increases Colorectal Cancer Screening Uptake

Cited by 52 publications

References 15 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

A cluster randomised trial of strategies to increase cervical screening uptake at first invitation (STRATEGIC)

A community‐based trial of educational interventions with fecal immunochemical tests for colorectal cancer screening uptake among blacks in community settings

Contact Info

Product

Resources

About