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document
Reducing cancer screening disparities in medicare beneficiaries through cancer patient navigation . Significant racial disparities in cancer mortality are seen between Medicare beneficiaries . A randomized controlled trial tested the use of lay navigators ( care managers ) to increase cancer screening of Asian and Pacific Islander Medicare beneficiaries . The study setting was Moloka'i General Hospital on the island of Moloka'i , Hawai'i , which was one of six sites participating in the Cancer Prevention and Treatment Demonstration sponsored by the Centers for Medicare and Medicaid Services . Between 2006 and 2009 , 488 Medicare beneficiaries ( 45 % Hawaiian , 35 % Filipino , 11 % Japanese , 8 % other ) were randomized to have a navigator help them access cancer screening services ( experimental condition , n = 242 ) or cancer education ( control condition , n = 246 ) . Self-reported data on screening participation were collected at baseline and exit from the study , and differences were tested using chi-square . Groups were similar in demographic characteristics and baseline screening prevalence of breast , cervical , prostate , and colorectal cancers . At study exit , 57.0 % of women in the experimental arm and 36.4 % of controls had had a Papanicolaou test in the past 24 months ( P = .001 ) , 61.7 % of women in the experimental arm and 42.4 % of controls had had a mammogram in the past 12 months ( P = .003 ) , 54.4 % of men in the experimental arm and 36.0 % of controls had had a prostate-specific antigen test in the past 12 months ( P = .008 ) , and 43.0 % of both sexes in the experimental arm and 27.2 % of controls had had a flexible sigmoidoscopy or colonoscopy in the past 5 years ( P < .001 ) . Findings suggest that navigation services can increase cancer screening in Medicare beneficiaries in groups with significant disparities .
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Intervention_Physical
cancer patient navigation
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Intervention_Physical
lay navigators ( care managers ) to increase cancer screening
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Intervention_Physical
navigator help them access cancer screening services ( experimental condition
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Intervention_Control
cancer education
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Intervention_Physical
baseline
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Intervention_Other
navigation services
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Outcome_Mental
cancer screening
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Outcome_Mortality
cancer mortality
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Outcome_Mental
cancer screening
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Outcome_Mental
Self-reported data on screening participation
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Outcome_Mental
Papanicolaou test
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Outcome_Mental
mammogram
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Outcome_Mental
prostate-specific antigen test in the past 12 months
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Outcome_Mental
flexible sigmoidoscopy or colonoscopy in the past 5 years
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Outcome_Mental
cancer screening
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Participant_Condition
cancer patient navigation
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Participant_Sample-size
488 Medicare beneficiaries
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Participant_Sample-size
45 % Hawaiian
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Participant_Sample-size
35 % Filipino
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Participant_Sample-size
11 % Japanese
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Participant_Sample-size
8 % other