TY - JOUR
T1 - Beneficial effects of a combined navigator/promotora approach for hispanic women diagnosed with breast abnormalities
AU - Dudley, Donald J.
AU - Drake, Joan
AU - Quinlan, Jennifer
AU - Holden, Alan
AU - Saegert, Pam
AU - Karnad, Anand
AU - Ramirez, Amelie
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2012/10
Y1 - 2012/10
N2 - Background: Patient navigation (PN) is an emerging strategy to overcome barriers to cancer care. We evaluated the efficacy of PN in improving time of key events in cancer care, including positive screening tests, definitive diagnosis, initiation of therapy, and completion of initial therapy. Methods: We evaluated PN in a prospective observational study of predominantly poor Hispanic women with an abnormal breast cancer screening or untreated biopsy proven breast cancer (control = 200, intervention = 260). Controls were contemporary record-based patients with positive screening. Analyses were conducted for the entire cohort and separately by ethnic strata. We used χ2 tests to compare differences in proportions and Kaplan-Meier followed by Cox regression to compare time-to-event curves of the intervention and control groups. Results: The average days from definitive diagnosis to initiation of therapy was significantly reduced overall withPN(PN vs. control, 57 vs. 74 days, P = 0.04). This effect was more pronounced in the Hispanic strata (56 vs. 81 days, P = 0.02). More navigated Hispanic women were diagnosed within 60 days of abnormal screening (62.6% vs. 47.5%, P < 0.01) and more began treatment within 60 days of diagnosis (80% vs. 56.3%, P < 0.01). Navigated Hispanic and other ethnic minority women had a shorter time from positive screening test to definitive diagnosis (16 and 32 days, respectively). Conclusions: Minority women may have benefited from navigation with shorter times from definitive diagnosis to initiation of therapy. Impact: PN intervention may show promise in decreasing some delays that contribute to health disparities among minority women with breast cancer.
AB - Background: Patient navigation (PN) is an emerging strategy to overcome barriers to cancer care. We evaluated the efficacy of PN in improving time of key events in cancer care, including positive screening tests, definitive diagnosis, initiation of therapy, and completion of initial therapy. Methods: We evaluated PN in a prospective observational study of predominantly poor Hispanic women with an abnormal breast cancer screening or untreated biopsy proven breast cancer (control = 200, intervention = 260). Controls were contemporary record-based patients with positive screening. Analyses were conducted for the entire cohort and separately by ethnic strata. We used χ2 tests to compare differences in proportions and Kaplan-Meier followed by Cox regression to compare time-to-event curves of the intervention and control groups. Results: The average days from definitive diagnosis to initiation of therapy was significantly reduced overall withPN(PN vs. control, 57 vs. 74 days, P = 0.04). This effect was more pronounced in the Hispanic strata (56 vs. 81 days, P = 0.02). More navigated Hispanic women were diagnosed within 60 days of abnormal screening (62.6% vs. 47.5%, P < 0.01) and more began treatment within 60 days of diagnosis (80% vs. 56.3%, P < 0.01). Navigated Hispanic and other ethnic minority women had a shorter time from positive screening test to definitive diagnosis (16 and 32 days, respectively). Conclusions: Minority women may have benefited from navigation with shorter times from definitive diagnosis to initiation of therapy. Impact: PN intervention may show promise in decreasing some delays that contribute to health disparities among minority women with breast cancer.
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U2 - 10.1158/1055-9965.EPI-12-0538
DO - 10.1158/1055-9965.EPI-12-0538
M3 - Article
C2 - 23045538
AN - SCOPUS:84867308051
VL - 21
SP - 1639
EP - 1644
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
SN - 1055-9965
IS - 10
ER -