Talar W Markossian1, Julie S Darnell, Elizabeth A Calhoun. 1. Jiann-Ping Hsu College of Public Health, Georgia Southern University, 501 Forest Drive, P.O. Box 8015, Statesboro, GA 30460, USA. tmarkossian@georgiasouthern.edu
Abstract
BACKGROUND: We evaluated the efficacy of a Chicago-based cancer patient navigation program developed to increase the proportion of patients reaching diagnostic resolution and reduce the time from abnormal screening test to definitive diagnostic resolution. METHODS: Women with an abnormal breast (n = 352) or cervical (n = 545) cancer screening test were recruited for the quasi-experimental study. Navigation subjects originated from five federally qualified health center sites and one safety net hospital. Records-based concurrent control subjects were selected from 20 sites. Control sites had similar characteristics to the navigated sites in terms of patient volume, racial/ethnic composition, and payor mix. Mixed-effects logistic regression and Cox proportional hazard regression analyses were conducted to compare navigation and control patients reaching diagnostic resolution by 60 days and time to resolution, adjusting for demographic covariates and site. RESULTS: Compared with controls, the breast navigation group had shorter time to diagnostic resolution (aHR = 1.65, CI = 1.20-2.28) and the cervical navigation group had shorter time to diagnostic resolution for those who resolved after 30 days (aHR = 2.31, CI = 1.75-3.06), with no difference before 30 days (aHR = 1.42, CI = 0.83-2.43). Variables significantly associated with longer time to resolution for breast cancer screening abnormalities were being older, never partnered, abnormal mammogram and BI-RADS 3, and being younger and Black for cervical abnormalities. CONCLUSIONS: Patient navigation reduces time from abnormal cancer finding to definitive diagnosis in underserved women. IMPACT: Results support efforts to use patient navigation as a strategy to reduce cancer disparities among socioeconomically disadvantaged women. 2012 AACR
BACKGROUND: We evaluated the efficacy of a Chicago-based cancerpatient navigation program developed to increase the proportion of patients reaching diagnostic resolution and reduce the time from abnormal screening test to definitive diagnostic resolution. METHODS:Women with an abnormal breast (n = 352) or cervical (n = 545) cancer screening test were recruited for the quasi-experimental study. Navigation subjects originated from five federally qualified health center sites and one safety net hospital. Records-based concurrent control subjects were selected from 20 sites. Control sites had similar characteristics to the navigated sites in terms of patient volume, racial/ethnic composition, and payor mix. Mixed-effects logistic regression and Cox proportional hazard regression analyses were conducted to compare navigation and control patients reaching diagnostic resolution by 60 days and time to resolution, adjusting for demographic covariates and site. RESULTS: Compared with controls, the breast navigation group had shorter time to diagnostic resolution (aHR = 1.65, CI = 1.20-2.28) and the cervical navigation group had shorter time to diagnostic resolution for those who resolved after 30 days (aHR = 2.31, CI = 1.75-3.06), with no difference before 30 days (aHR = 1.42, CI = 0.83-2.43). Variables significantly associated with longer time to resolution for breast cancer screening abnormalities were being older, never partnered, abnormal mammogram and BI-RADS 3, and being younger and Black for cervical abnormalities. CONCLUSIONS:Patient navigation reduces time from abnormal cancer finding to definitive diagnosis in underserved women. IMPACT: Results support efforts to use patient navigation as a strategy to reduce cancer disparities among socioeconomically disadvantaged women. 2012 AACR
Authors: R A Hiatt; R J Pasick; S Stewart; J Bloom; P Davis; P Gardiner; M Johnston; J Luce; K Schorr; W Brunner; F Stroud Journal: Prev Med Date: 2001-09 Impact factor: 4.018
Authors: K Robin Yabroff; Kathleen Shakira Washington; Amy Leader; Elizabeth Neilson; Jeanne Mandelblatt Journal: Med Care Res Rev Date: 2003-09 Impact factor: 3.929
Authors: Laszlo Tabar; Ming-Fang Yen; Bedrich Vitak; Hsiu-Hsi Tony Chen; Robert A Smith; Stephen W Duffy Journal: Lancet Date: 2003-04-26 Impact factor: 79.321
Authors: Tracy A Battaglia; Julie S Darnell; Naomi Ko; Fred Snyder; Electra D Paskett; Kristen J Wells; Elizabeth M Whitley; Jennifer J Griggs; Anand Karnad; Heather Young; Victoria Warren-Mears; Melissa A Simon; Elizabeth Calhoun Journal: Breast Cancer Res Treat Date: 2016-07-18 Impact factor: 4.872
Authors: Ambili Ramachandran; Frederick R Snyder; Mira L Katz; Julie S Darnell; Donald J Dudley; Steven R Patierno; Mechelle R Sanders; Patricia A Valverde; Melissa A Simon; Victoria Warren-Mears; Tracy A Battaglia Journal: Cancer Date: 2015-08-19 Impact factor: 6.860
Authors: Mira L Katz; Gregory S Young; Paul L Reiter; Tracy A Battaglia; Kristen J Wells; Mechelle Sanders; Melissa Simon; Donald J Dudley; Steven R Patierno; Electra D Paskett Journal: Womens Health Issues Date: 2014 Jan-Feb
Authors: Ashley Meilleur; S V Subramanian; Jesse J Plascak; James L Fisher; Electra D Paskett; Elizabeth B Lamont Journal: Cancer Epidemiol Biomarkers Prev Date: 2013-10 Impact factor: 4.254
Authors: Karen M Freund; Tracy A Battaglia; Elizabeth Calhoun; Julie S Darnell; Donald J Dudley; Kevin Fiscella; Martha L Hare; Nancy LaVerda; Ji-Hyun Lee; Paul Levine; David M Murray; Steven R Patierno; Peter C Raich; Richard G Roetzheim; Melissa Simon; Frederick R Snyder; Victoria Warren-Mears; Elizabeth M Whitley; Paul Winters; Gregory S Young; Electra D Paskett Journal: J Natl Cancer Inst Date: 2014-06-17 Impact factor: 13.506
Authors: Simon Craddock Lee; Robin T Higashi; Joanne M Sanders; Hong Zhu; Stephen J Inrig; Caroline Mejias; Keith E Argenbright; Jasmin A Tiro Journal: Cancer Causes Control Date: 2018-08-23 Impact factor: 2.506
Authors: Yamile Molina; Anne E Glassgow; Sage J Kim; Nerida M Berrios; Heather Pauls; Karriem S Watson; Julie S Darnell; Elizabeth A Calhoun Journal: Contemp Clin Trials Date: 2016-12-08 Impact factor: 2.226