Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Racial disparities in CRC incidence and mortality have been well documented. In addition, lower rates of CRC screening among ethnic minorities have been reported. Therefore, we tested the effectiveness of a patient navigator (PN) in increasing compliance with CRC screening in a minority community health setting. Men and women aged 50 or older attending a primary care practice were enrolled if they had not had a fecal occult blood test within the past year, a sigmoidoscopy or barium enema within the past 3–5 years, or a colonoscopy within the past 10 years. Participants were randomly assigned either to receive navigator services (PN+) or not to receive navigator services (PN−). There were no demographic differences between the two groups. Within 6 months of physician recommendation, 15.8% in the PN+ group had complied with an endoscopic examination, compared with only 5% in the PN− group (P=.019). The PN+ groups also demonstrated higher rates of fecal occult blood test completion (42.1% vs. 25%, P=.086). Thus, a PN system successfully increases CRC screening rates among a predominantly minority population of low socioeconomic status.
The Full Text of this article is available as a PDF
These references are in PubMed. This may not be the complete list of references from this article.
1. Greenlee RT, Hill-Harmonn MB, Murray T, Thun M. Cancer statistics, 2001. CA Cancer J Clin. 2001;51:15–36. doi: 10.3322/canjclin.51.1.15. [PubMed] [Cross Ref] 2. Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ. Cancer statistics, 2003. CA Cancer J Clin. 2003;53:5–26. doi: 10.3322/canjclin.53.1.5. [PubMed] [Cross Ref]
3. Cancer Prevention and Control. Comparison of use of colorectal cancer tests with other cancer screening tests, NHIS 2000. Available at: http:/www.cdc.gov/cancer/colorctl/calltoaction/slides_index.htm (slide35). Accessed April 11, 2005.
4. National Cancer Institute. SEER cancer statistics review 1973–1997. Available at: http://seer.cancer.gov/csr/1973_1997/colorect.pdf. Accessed April 5, 2005.
5. Behavioral Risk Factor Surveillance System. Technical information and data. Available at: http://www.cdc.gov/brfss/technical_infodata/surveydata/1997.htm. Accessed April 5, 2005.
6. Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med. 1993;328:1365–1371. doi: 10.1056/NEJM199305133281901. [PubMed] [Cross Ref] 7. Mandel JS, Church TR, Bond JH, et al. The effect of fecal occult-blood screening on the incidence of colorectal cancer. N Engl J Med. 2000;343:1603–1607. doi: 10.1056/NEJM200011303432203. [PubMed] [Cross Ref] 8. Hardcastle JD, Chamberlain JO, Robinson MH, et al. Randomised controlled trial of faecaloccult-blood screening for colorectal cancer. Lancet. 1996;348:1472–1477. doi: 10.1016/S0140-6736(96)03386-7. [PubMed] [Cross Ref] 9. Burt RW. Colon cancer screening. Gastroenterology. 2000;119:837–853. doi: 10.1053/gast.2000.16508. [PubMed] [Cross Ref] 10. Newcomb PA, Norfleet RG, Storer E, Surawicz TS, Marcus PM. Screening sigmoidoscopy and colorectal cancer mortality. J Natl Cancer Inst. 1992;84:1572–1575. doi: 10.1093/jnci/84.20.1572. [PubMed] [Cross Ref] 11. Selby JV, Friedman GD, Quesenberry CP, Jr, Weiss NS. A case-control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med. 1992;326:653–702. doi: 10.1056/NEJM199203053261001. [PubMed] [Cross Ref] 12. Tingen MS, Weinrich SP, Heydt DD, Boyd MD, Weinrich MC. Perceived benefits: a predictor of participation in prostate cancer screening. Cancer Nurs. 1998;21:349–357. doi: 10.1097/00002820-199810000-00006. [PubMed] [Cross Ref] 13. Frelix GD, Rosenblatt R, Solomon M, Vikram B. Breast cancer screening in underserved women in the Bronx. J Natl Med Assoc. 1999;91:195–200. [PMC free article] [PubMed] 14. Freeman HP, Muth BJ, Kerner JF. Expanding access to cancer screening and clinical follow-up among the medically underserved. Cancer Pract. 1995;3:19–30. [PubMed] 15. Gauthier MA, Clarke WP. Gaining and sustaining minority participation in longitudinal research projects. Alzheimer Dis Assoc Disord. 1999;13:S29–S33. doi: 10.1097/00002093-199904001-00008. [PubMed] [Cross Ref] 16. Stoy DB, Curtis RC, Dameworth KS, et al. The successful recruitment of elderly black subjects in a clinical trial: the CRISP experience. Cholesterol Reduction in Seniors Program. J Natl Med Assoc. 1995;87:280–287. [PMC free article] [PubMed]