NEW YORK (Reuters Health) - Minorities in the U.S. have particularly low rates of colon cancer screening, but guidance from a patient "navigator" might help more people get tested, a study suggests.
Researchers at Mount Sinai Hospital in New York found that after they hired a patient navigator to help guide patients through the screening colonoscopy process, the rate of completed screenings among their mostly black and Hispanic patients increased to 66 percent. That compares with a city-wide rate of about 47 percent for New Yorkers older than 50.
The findings are published in the journal Clinical Gastroenterology and Hepatology.
Patient navigators are trained professionals, including nurses, social workers and health educators, who help patients negotiate their way through the health care system. They may, for example, help in scheduling appointments with different doctors, arrange for transportation to those appointments or help answer patients' questions about a test or procedure.
Patient navigator programs have typically been reserved for people who have cancer or who have an abnormal result on a cancer screening test.
But the new findings suggest that patient navigators could also get more people into colon cancer screening in the first place, according to the researchers.
"We saw a substantial uptake in the colonoscopy completion rate with the introduction of a patient navigator, as well as a remarkable decline in the appointment no-show rate," senior researcher Dr. Steven Itzkowitz said in a statement.
The study included 532 men and women who were referred for colonoscopy screening and received help from the center's patient navigator. Eighty-eight percent were African-American or Hispanic.
The patient navigator helped explain the procedure to the patients, scheduled their appointment, called to remind them of the appointment and arranged for transportation when necessary.
Overall, two-thirds of the patients had their colonoscopy, thanks in part to a large drop in the number who simply did not show for their appointment. Historically, the researchers note, the rate of no-shows at their center has hovered around 40 percent; that decreased to less than 10 percent after they started the patient navigator program.
"These rates are certainly higher than those reported in other studies investigating colonoscopy follow-through in minority populations, and we attribute this to the individual intervention with the patient navigator," Itzkowitz said.
The New York City health department is now working on developing similar programs throughout the city, according to Itzkowitz.
SOURCE: Clinical Gastroenterology and Hepatology, April 2008.
