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
. 2015 Nov 15;121(22):4025-34.
doi: 10.1002/cncr.29612. Epub 2015 Sep 8.

Impact of patient navigation in eliminating economic disparities in cancer care

Angie Mae Rodday  1 , Susan K Parsons  1 , Frederick Snyder  2 , Melissa A Simon  3   4   5 , Adana A M Llanos  6   7 , Victoria Warren-Mears  8 , Donald Dudley  9 , Ji-Hyun Lee  10   11 , Steven R Patierno  12   13 , Talar W Markossian  14 , Mechelle Sanders  15 , Elizabeth M Whitley  16 , Karen M Freund  1
Affiliations

Impact of patient navigation in eliminating economic disparities in cancer care

Angie Mae Rodday et al. Cancer. .

Abstract

Background: Patient navigation may reduce cancer disparities associated with socioeconomic status (SES) and household factors. This study examined whether these factors were associated with delays in diagnostic resolution among patients with cancer screening abnormalities and whether patient navigation ameliorated these delays.

Methods: This study analyzed data from 5 of 10 centers of the National Cancer Institute's Patient Navigation Research Program, which collected SES and household data on employment, income, education, housing, marital status, and household composition. The primary outcome was the time to diagnostic resolution after a cancer screening abnormality. Separate adjusted Cox proportional hazard models were fit for each SES and household factor, and an interaction between that factor and the intervention status was included.

Results: Among the 3777 participants (1968 in the control arm and 1809 in the navigation intervention arm), 91% were women, and the mean age was 44 years; 43% were Hispanic, 28% were white, and 27% were African American. Within the control arm, the unemployed experienced a longer time to resolution than those employed full-time (hazard ratio [HR], 0.85; P = .02). Renters (HR, 0.81; P = .02) and those with other (ie, unstable) housing (HR, 0.60; P < .001) had delays in comparison with homeowners. Never married (HR, 0.70; P < .001) and previously married participants (HR, 0.85; P = .03) had a longer time to care than married participants. There were no differences in the time to diagnostic resolution with any of these variables within the navigation intervention arm.

Conclusions: Delays in diagnostic resolution exist by employment, housing type, and marital status. Patient navigation eliminated these disparities in the study sample. These findings demonstrate the value of providing patient navigation to patients at high risk for delays in cancer care.

Trial registration: ClinicalTrials.gov NCT00375024 NCT00496678 NCT00613275 NCT01569672.

Keywords: breast neoplasms; colonic neoplasms; early detection of cancer; health care disparities; patient navigation; prostatic neoplasms; uterine cervical neoplasms.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan-Meier curves for impact of patient navigation and marital status on time to diagnostic resolution following an abnormal cancer screening event.
Figure 2
Figure 2
Kaplan-Meier curves for impact of patient navigation and housing status on time to diagnostic resolution following an abnormal cancer screening event.
See this image and copyright information in PMC

Comment in

References

    1. Ward E, Jemal A, Cokkinides V, et al. Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clin. 2004;54:78–93. - PubMed
    1. Clegg LX, Reichman ME, Miller BA, et al. Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study. Cancer Causes Control. 2009;20:417–435. - PMC - PubMed
    1. Thuret R, Sun M, Budaus L, et al. A population-based analysis of the effect of marital status on overall and cancer-specific mortality in patients with squamous cell carcinoma of the penis. Cancer Causes Control. 2013;24:71–79. - PubMed
    1. Simard EP, Fedewa S, Ma J, Siegel R, Jemal A. Widening socioeconomic disparities in cervical cancer mortality among women in 26 states, 1993-2007. Cancer. 2012;118:5110–5116. - PubMed
    1. Tannenbaum SL, Koru-Sengul T, Miao F, Byrne MM. Disparities in survival after female breast cancer diagnosis: a population-based study. Cancer Causes Control. 2013;24:1705–1715. - PubMed

Publication types

Associated data