abstract
BACKGROUND:
Patient
navigation (PN) is a patient-centered health-care service delivery
model that assists individuals, particularly the medically underserved,
in overcoming barriers (e.g., personal, logistical, and system) to care
across the cancer care continuum. In 2012, the American College of
Surgeons Commission on Cancer (CoC) announced that health-care
facilities seeking CoC-accreditation must have PN processes in place
starting January 1, 2015. The CoC mandate, in light of the recent
findings from centers within the Patient Navigation Research Program and
the influx of PN interventions, warrants the present literature review.
METHODS:
PubMed
and Medline were searched for studies published from January 2010 to
October 2015, particularly those recent articles within the past
2 years, addressing PN for breast and gynecological cancers, and written
in English. Search terms included patient navigation, navigation,
navigator, cancer screening, clinical trials, cancer patient, cancer
survivor, breast cancer, gynecological cancer, ovarian cancer, uterine
cancer, vaginal cancer, and vulvar cancer.
RESULTS:
Consistent
with prior reviews, PN was shown to be effective in helping women who
receive cancer screenings, receive more timely diagnostic resolution
after a breast and cervical cancer screening abnormality, initiate
treatment sooner, receive proper treatment, and improve quality of life
after cancer diagnosis. However, several limitations were observed. The
majority of PN interventions focused on cancer screening and diagnostic
resolution for breast cancer. As observed in prior reviews,
methodological rigor (e.g., randomized controlled trial design) was
lacking.
CONCLUSION:
Future
research opportunities include testing PN interventions in the
post-treatment settings and among gynecological cancer patient
populations, age-related barriers to effective PN, and collaborative
efforts between community health workers and patient navigators as care
goes across segments of the cancer control continuum. As PN programs
continue to develop and become a standard of care, further research will
be required to determine the effectiveness of cancer PN across the
cancer care continuum, and in different patient populations.
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