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document
Patient navigation improves cancer diagnostic resolution : an individually randomized clinical trial in an underserved population . BACKGROUND Barriers to timely resolution of abnormal cancer screening tests add to cancer health disparities among low-income , uninsured , and minority populations . We conducted a randomized trial to evaluate the impact of lay patient navigators on time to resolution and completion of follow-up testing among patients with abnormal screening tests in a medically underserved patient population . METHODS Denver Health , the safety-net health care system serving Denver , is one of 10 performance sites participating in the Patient Navigation Research Program . Of 993 eligible subjects with abnormal screening tests randomized to navigation and no-navigation ( control ) arms and analyzed , 628 had abnormal breast screens ( 66 abnormal clinical breast examinations , 304 BIRADS 0 , 200 BIRADS 3 , 58 BIRADS 4 or 5 ) whereas 235 had abnormal colorectal and 130 had abnormal prostate screens . RESULTS Time to resolution was significantly shorter in the navigated group ( stratified log rank test , P < 0.001 ) . Patient navigation improved diagnostic resolution for patients presenting with mammographic BIRADS 3 ( P = 0.0003 ) and BIRADS 0 ( P = 0.09 ) , but not BIRADS 4/5 or abnormal breast examinations . Navigation shortened the time for both colorectal ( P = 0.0017 ) and prostate screening resolution ( P = 0.06 ) . Participant demographics included 72 % minority , 49 % with annual household income less than $ 10,000 , and 36 % uninsured . CONCLUSIONS Patient navigation positively impacts time to resolution of abnormal screening tests for breast , colorectal , and prostate cancers in a medically underserved population . IMPACT By shortening the time to and increasing the proportion of patients with diagnostic resolution patient navigation could reduce disparities in stage at diagnosis and improve cancer outcomes .
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Intervention_Educational
Patient navigation
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Intervention_Educational
lay patient navigators
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Intervention_Educational
navigation
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Intervention_Control
no-navigation ( control )
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Intervention_Educational
Patient navigation
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Intervention_Educational
Patient navigation
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Outcome_Other
Time to resolution
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Outcome_Other
diagnostic resolution
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Outcome_Other
colorectal
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Outcome_Other
prostate screening resolution
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Outcome_Other
resolution
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Participant_Condition
underserved population .
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Participant_Condition
low-income , uninsured , and minority populations .
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Participant_Condition
Participant demographics included 72 % minority , 49 % with annual household income less than $ 10,000 , and 36 % uninsured .