Abstract
Breast cancer screening combined with follow-up and treatment reduces breast cancer mortality. However, in the study clinic, only 12 % of eligible women ≥40 years received a mammogram in the previous year. The objective of this project was to implement patient navigation, in our partner health clinic to (1) identify women overdue for a mammogram; and (2) increase mammography utilization in this population over a 2-year period. Women overdue for a mammogram were identified. One patient navigator made navigation attempts over a 2-year period (2009–2011). Navigation included working around systems- and individual-level barriers to receive a mammogram as well as the appropriate follow-up post screening. Women were contacted up to three times to initiate navigation. The proportion of women navigated and who received a mammogram during the study period were compared to women who did not receive a mammogram using Chi square tests for categorical variables and t tests for continuous variables with an α = 0.05. Barriers to previous mammography were also assessed. With 94.8 % of eligible women navigated and 94 % of these women completing mammography, the implementation project reached 89 % of the target population. This project was a successful implementation of an evidence-based patient navigation program that continues to provide significant impact in a high-need area. Cost was the most commonly cite barrier to mammography. Increasing awareness of resources in the community for mammography and follow-up care remains a necessary adjunct to removing structural and financial barriers to accessing preventive services.
Highlights
Breast cancer screening combined with appropriate followup and treatment reduces breast cancer mortality [1]
Navigation contributes to the early detection of breast cancer by reducing barriers such as income, insurance status, access to care and facility to navigate through care among women to obtain breast cancer screening [10, 11]
The first patient navigation program was started in New York to increase the delivery of mammography screening to Black women who were too often presenting with advanced cancer as a result of a lack of screening [12]
Summary
Breast cancer screening combined with appropriate followup and treatment reduces breast cancer mortality [1]. Studies suggest that many women begin regular mammography screening later than recommended, do not have mammograms at recommended intervals, and do not receive appropriate and timely follow-up [2,3,4]. This is especially true for women living in areas with minimal access to medical facilities. Navigation contributes to the early detection of breast cancer by reducing barriers such as income, insurance status, access to care and facility to navigate through care among women to obtain breast cancer screening [10, 11]. The process of patient navigation facilitates access to quality medical care by identifying barriers to care and bridging
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