Beneficial effects of a combined navigator/promotora approach for hispanic women diagnosed with breast abnormalities

Donald J. Dudley, Joan Drake, Jennifer Quinlan, Alan Holden, Pam Saegert, Anand Karnad, Amelie Ramirez

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1639-1644
Number of pages6
JournalCancer Epidemiology Biomarkers and Prevention
Volume21
Issue number10
DOIs
StatePublished - Oct 2012

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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