Beneficial effects of a combined navigator/promotora approach for Hispanic women diagnosed with breast abnormalities.
Cancer Epidemiol Biomarkers Prev
; 21(10): 1639-44, 2012 Oct.
Article
em En
| MEDLINE
| ID: mdl-23045538
ABSTRACT
BACKGROUND:
Patient navigation (PN) is an emerging strategy to overcome barriers to cancer care. We evaluated the efficacy of PN in improving time of key events in cancer care, including positive screening tests, definitive diagnosis, initiation of therapy, and completion of initial therapy.METHODS:
We evaluated PN in a prospective observational study of predominantly poor Hispanic women with an abnormal breast cancer screening or untreated biopsy proven breast cancer (control = 200, intervention = 260). Controls were contemporary record-based patients with positive screening. Analyses were conducted for the entire cohort and separately by ethnic strata. We used χ(2) tests to compare differences in proportions and Kaplan-Meier followed by Cox regression to compare time-to-event curves of the intervention and control groups.RESULTS:
The average days from definitive diagnosis to initiation of therapy was significantly reduced overall with PN (PN vs. control, 57 vs. 74 days, P = 0.04). This effect was more pronounced in the Hispanic strata (56 vs. 81 days, P = 0.02). More navigated Hispanic women were diagnosed within 60 days of abnormal screening (62.6% vs. 47.5%, P < 0.01) and more began treatment within 60 days of diagnosis (80% vs. 56.3%, P < 0.01). Navigated Hispanic and other ethnic minority women had a shorter time from positive screening test to definitive diagnosis (16 and 32 days, respectively).CONCLUSIONS:
Minority women may have benefited from navigation with shorter times from definitive diagnosis to initiation of therapy. IMPACT PN intervention may show promise in decreasing some delays that contribute to health disparities among minority women with breast cancer.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
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Saude_da_mulher
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Mama
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Tipos_de_cancer
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Mama
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Outros_tipos
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Mama
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Navegação de Pacientes
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Middle aged
Idioma:
En
Revista:
Cancer Epidemiol Biomarkers Prev
Assunto da revista:
BIOQUIMICA
/
EPIDEMIOLOGIA
/
NEOPLASIAS
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Estados Unidos