Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2013 May;22(5):426-31.
doi: 10.1089/jwh.2012.3900. Epub 2013 Apr 26.

The impact of a culturally tailored patient navigator program on cervical cancer prevention in Latina women

Sanja Percac-Lima  1 , Carly S Benner, Raymond Lui, Leslie S Aldrich, Sarah A Oo, Nessa Regan, Bruce A Chabner
Affiliations
Comparative Study

The impact of a culturally tailored patient navigator program on cervical cancer prevention in Latina women

Sanja Percac-Lima et al. J Womens Health (Larchmt). 2013 May.

Abstract

Background: Cervical cancer disproportionately affects Latina women in the United States. This study evaluated the impact of patient navigation on cervical cancer prevention in Latinas.

Methods: Between January 2004 and April 2011, 533 Latina women with an abnormal Pap smear requiring colposcopy received patient navigation from their healthcare center in Chelsea, Massachusetts, to the Massachusetts General Hospital (MGH). The comparison group comprised 253 non-navigated Latinas from other primary care practices at MGH referred to the same MGH colposcopy clinic. Primary outcomes were the percentage of missed colposcopy appointments, time to colposcopy, and changes in the severity of cervical pathology at colposcopy over two time periods, 2004-2007 and 2008-2011.

Results: The mean age in both groups was 35 years (range 22-86). Navigated women had fewer missed colposcopy appointments over time, with the average falling from 19.8% to 15.7% (p=0.024), compared with an insignificant increase in the no-show rates from 18.6% to 20.6% (p=0.454) in the comparison group. The difference in the no-show rate trend over time between the groups was significant (p<0.001). The time to colposcopy did not change in either group, though trends over time demonstrated a shorter follow-up for navigated women (p=0.010). The grade of cervical abnormality among navigated women decreased from a numerical score of 2.03 to 1.83 (p=0.035) over the two time intervals, while the severity of pathological score in the non-navigated group did not change significantly from 1.83 to 1.92 (p=0.573) in the same interval. Comparison of trends in pathological score over time showed a decrease in the severity of cervical abnormality for navigated participants compared to the non-navigated group (p<0.001).

Conclusion: Patient navigation can prevent cervical cancer in Latina women by increasing colposcopy clinic attendance, shortening time to colposcopy, and decreasing severity of cervical abnormalities over time.

PubMed Disclaimer

Figures

FIG. 1.
FIG. 1.
Percentage of missed colposcopy appointments over time.
FIG. 2.
FIG. 2.
Effect of patient navigation on severity of colposcopy diagnosis over time.
FIG. 3.
FIG. 3.
Distribution of colposcopy lesions severity over time in navigated and comparison groups.
See this image and copyright information in PMC

References

    1. Michalas SP. The Pap test: George N. Papanicolaou (1883–1962). A screening test for the prevention of cancer of uterine cervix. Eur J Obstet Gynecol Reprod Biol. 2000;90:135–138. - PubMed
    1. Downs LS. Smith JS. Scarinci I. Flowers L. Parham G. The disparity of cervical cancer in diverse populations. Gynecol Oncol. 2008;109(Suppl 2):22–30. - PubMed
    1. Siegel R. Naishadham D. Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62:10–29. - PubMed
    1. Surveillance Epidemiology and End Results. Bethesda, MD: National Cancer Institute; 2012. [Jul 20;2012 ]. SEER stat fact sheets: Cancer of the cervix uteri.
    1. Percac-Lima S. Aldrich LS. Gamba GB. Bearse AM. Atlas SJ. Barriers to follow-up of an abnormal Pap smear in Latina women referred for colposcopy. J Gen Inten Med. 2010;25:1198–1204. - PMC - PubMed

Publication types