Abstract PL06-03: Effect of patient navigation on time from definitive diagnosis to initiation of treatment (T2) for breast, prostate, colorectal, and cervical cancers

Abstract

Abstract Background: Barriers to timely initiation of treatment in newly diagnosed cancer patients may add to cancer health disparities of low income, uninsured and minority populations. Objectives: To conduct a clinical trial to evaluate the impact of patient navigation on the time from cancer diagnosis to initiation of the first treatment in a medically underserved patient population. Methods: Nine sites participated in the National Cancer Institute Patient Navigation Research Program (PNRP) study. 2,107 cancer patients enrolled in the study, 1,033 in the navigated and 1,074 in the control groups. Analysis was on the individual patient level, due to site population heterogeneity. Results: Demographics included 39% Black, 32% White, and 27% Hispanic; 85% female, 15% male. Insurance status included 17% uninsured, 45% public, and 38% private. The navigated and control groups were well balanced for major covariates. Mean and median times from diagnosis to first treatment were not impacted by patient navigation. Treatment patterns did differ in that more mastectomies were performed in the control vs. navigated breast cancer patients (32 vs. 21%), while more cone biopsies (23 vs. 15%) and fewer LEEP procedures (49 vs. 65%) were performed in the control vs. navigated cervix cancer patients. Implications: Patient navigation did not impact the time from cancer diagnosis to start of first treatment in a medically underserved population, while it may have impacted certain patterns of care. Next Steps: We plan further analyses by site and cancer type, assess covariate effects, perform a sensitivity analysis, and assess patient-navigator interactions. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):PL06-03.