Abstract
Patient navigation has been proposed to combat cancer disparities in vulnerable populations. Vulnerable populations often have poorer cancer outcomes and lower levels of screening, adherence, and treatment. Navigation has been studied in various cancers, but few studies have assessed navigation in lung cancer. Additionally, there is a lack of consistency in metrics to assess the quality of navigation programs. The authors conducted a systematic review of published cancer screening studies to identify quality metrics used in navigation programs, as well as to recommend standardized metrics to define excellence in lung cancer navigation. The authors included 26 studies evaluating navigation metrics in breast, cervical, colorectal, prostate, and lung cancer. After reviewing the literature, the authors propose the following navigation metrics for lung cancer screening programs: (1) screening rate, (2) compliance with follow-up, (3) time to treatment initiation, (4) patient satisfaction, (5) quality of life, (6) biopsy complications, and (7) cultural competency.
Highlights
Vulnerable populations experience disparities in health care and health outcomes
The present review suggests quality metrics for future patient navigation programs focused on lung cancer in vulnerable populations
This systematic review indicates that patient navigator programs can improve screening rates, compliance with follow-up, time to treatment initiation, patient satisfaction, and quality of life among vulnerable populations
Summary
Vulnerable populations are defined as a disadvantaged subset of the community. Traditionally these subsets have included racial or ethnic minorities, socioeconomically disadvantaged individuals, uninsured/underinsured persons, children, and the elderly, more recent literature recognizes previously overlooked groups such as veterans, immigrants, prisoners, residents of rural communities, and trans/gender nonconforming persons.. Traditionally these subsets have included racial or ethnic minorities, socioeconomically disadvantaged individuals, uninsured/underinsured persons, children, and the elderly, more recent literature recognizes previously overlooked groups such as veterans, immigrants, prisoners, residents of rural communities, and trans/gender nonconforming persons.1,2 These vulnerable populations experience disparate health care access and health outcomes because of inequalities in social determinants of health.. Despite some racial groups being at high risk, it is important to note that not every individual in a racial minority is vulnerable These vulnerable populations experience disparate health care access and health outcomes because of inequalities in social determinants of health. In terms of outcomes in cancer care, disparities in time to diagnosis, curative treatment, and cancer-specific and overall mortality have been noted among black, Hispanic, and Asian patients with nearly every tumor type. Despite some racial groups being at high risk, it is important to note that not every individual in a racial minority is vulnerable
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