Evidence map›Paper›PMID 24938303›Full record

SynthesisJournal of the National Cancer Institute2014

Impact of patient navigation on timely cancer care: the Patient Navigation Research Program.

Karen M Freund, Tracy A Battaglia, Elizabeth Calhoun, Julie S Darnell, Donald J Dudley, Kevin Fiscella, Martha L Hare, Nancy LaVerda, Ji-Hyun Lee, Paul Levine and 12 more

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the National Cancer Institute, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 168 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
168citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

168 citing papers in PubMed, 12 syntheses or guidelines pooled it.

  1. Application of patient navigation programs across the entire continuum of breast cancer care: a GRADE-assessed systematic review with meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Pooled it
  2. Systematic Review of Interventions Addressing Racial and Ethnic Disparities in Cancer Care and Health Outcomes.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Adherence in the Cancer Care Setting: a Systematic Review of Patient Navigation to Traverse Barriers.Journal of cancer education : the official journal of the American Association for Cancer Education · 2018
    Pooled it
  11. Pooled it
  12. Pooled it
  13. Trial
  14. Trial
  15. Trial
  16. Effect of an Antiracism Intervention on Racial Disparities in Time to Lung Cancer Surgery.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022
    Trial
  17. Trial
  18. Patient Navigation for Colonoscopy Completion: Results of an RCT.American journal of preventive medicine · 2017
    Trial
  19. Trial
  20. Trial

108 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Karen M FreundAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Tracy A BattagliaAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Elizabeth CalhounAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Julie S DarnellAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Donald J DudleyAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Kevin FiscellaAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Martha L HareAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Nancy LaVerdaAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Ji-Hyun LeeAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Paul LevineAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
David M MurrayAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Steven R PatiernoAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Peter C RaichAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Richard G RoetzheimAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Melissa SimonAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Frederick R SnyderAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Victoria Warren-MearsAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Elizabeth M WhitleyAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Paul WintersAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Gregory S YoungAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Electra D PaskettAffiliations of authors: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, Comprehensive Cancer Center (EDP), and Center for Biostatistics (GSY), The Ohio State University, Columbus, OH; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA (KMF); Women's Health Unit, Section of General Internal Medicine, Evans Department of Medicine, Boston Medical Center and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, MA (TAB); Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL (EC, JSD); Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX (DLD); Department of Family Medicine and Public Health Sciences and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY (KF); Center to Reduce Cancer Health Disparities, National Cancer Institute (MLH), and Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (DMM), Rockville, MD (MLH); George Washington University School of Public Health and Health Services, Washington, DC (NL, PL); H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (J-HL, RGR); George Washington Cancer Institute, Washington, DC (PL. SRP); Duke Cancer Institute, Durham, NC (SRP); Denver Health, Denver, CO (PCR, EMW); University of Colorado Denver, Aurora, CO (PCR); Department of Family Medicine, University of South Florida, Tampa, FL (RGR); Department of Obstetrics and Gynecology and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (MS); Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL (MS); Clinical Research Ser
Writing Group of the Patient Navigation Research Program

Funding

Translational Therapeutics Research Program (TT)P30CA016058 · NCI · OHIO STATE UNIVERSITY · PI Jennifer A. Woyach · 1985 to 2026
$132.3M
TRANSLATIONAL RESEARCHP30CA076292 · NCI · UNIVERSITY OF SOUTH FLORIDA · PI Christine O'Connell · 1998 to 2026
$93.5M
Multidisciplinary Clinical and Translational Science (MCTS) Program (UL1)UL1TR000150 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI LLOYD-JONES, DONALD M · 2012 to 2013
$10.1M
Chicago Cancer Navigation ProjectU01CA116875 · NCI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI ROSEN, STEVEN TERRY · 2005 to 2011
$4.5M
RCT of Primary Care-based Patient Navigation-ActivationU01CA116924 · NCI · UNIVERSITY OF ROCHESTER · PI FISCELLA, KEVIN ANTHONY · 2005 to 2011
$4.4M
"Patient Navigation in the SafetyNet: CONNECTeDD"U01CA116892 · NCI · BOSTON MEDICAL CENTER · PI FREUND, KAREN · 2005 to 2010
$4.3M
DC City-wide Patient Navigation Research ProgramU01CA116937 · NCI · GEORGE WASHINGTON UNIVERSITY · PI PATIERNO, STEVEN R · 2005 to 2011
$4.1M
Improving Patient Outcomes Through System NavigationU01CA116903 · NCI · DENVER HEALTH AND HOSPITAL AUTHORITY · PI RAICH, PETER CHRISTIAN · 2005 to 2011
$3.8M
Patient Navigation Research ProgramU01CA116885 · NCI · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI DUDLEY, DONALD J · 2005 to 2010
$3.3M
Patient Navigator ProgramU01CA117281 · NCI · H. LEE MOFFITT CANCER CTR &RES INST · PI ROETZHEIM, RICHARD G · 2005 to 2009
$3.1M
Northwest Tribal Cancer Navigator ProgramU01CA116925 · NCI · NORTHWEST PORTLAND AREA INDIAN HLTH BD · PI WARREN-MEARS, VICTORIA ANN · 2005 to 2009
$3.0M
NCATS NIH HHS UL1 TR000150NCI NIH HHS 01CA116937NCI NIH HHS P30 CA016058NCI NIH HHS P30 CA076292NCI NIH HHS U01CA116875NCI NIH HHS U01CA116885NCI NIH HHS U01 CA116892NCI NIH HHS U01CA116903NCI NIH HHS U01CA116924NCI NIH HHS U01CA116925NCI NIH HHS U01 CA117281
6 · The paper itself

Abstract

backgroundPatient navigation is a promising intervention to address cancer disparities but requires a multisite controlled trial to assess its effectiveness.

methodsThe Patient Navigation Research Program compared patient navigation with usual care on time to diagnosis or treatment for participants with breast, cervical, colorectal, or prostate screening abnormalities and/or cancers between 2007 and 2010. Patient navigators developed individualized strategies to address barriers to care, with the focus on preventing delays in care. To assess timeliness of diagnostic resolution, we conducted a meta-analysis of center- and cancer-specific adjusted hazard ratios (aHRs) comparing patient navigation vs usual care. To assess initiation of cancer therapy, we calculated a single aHR, pooling data across all centers and cancer types. We conducted a metaregression to evaluate variability across centers. All statistical tests were two-sided.

resultsThe 10521 participants with abnormal screening tests and 2105 with a cancer or precancer diagnosis were predominantly from racial/ethnic minority groups (73%) and publically insured (40%) or uninsured (31%). There was no benefit during the first 90 days of care, but a benefit of navigation was seen from 91 to 365 days for both diagnostic resolution (aHR = 1.51; 95% confidence interval [CI] = 1.23 to 1.84; P < .001)) and treatment initiation (aHR = 1.43; 95% CI = 1.10 to 1.86; P < .007). Metaregression revealed that navigation had its greatest benefits within centers with the greatest delays in follow-up under usual care.

conclusionsPatient navigation demonstrated a moderate benefit in improving timely cancer care. These results support adoption of patient navigation in settings that serve populations at risk of being lost to follow-up.

Indexed as

Early Detection of CancerHealthcare DisparitiesPatient NavigationAdultAgedBlack or African AmericanBreast NeoplasmsColorectal NeoplasmsCommunication BarriersConfounding Factors, EpidemiologicControlled Clinical Trials as TopicFemaleHispanic or LatinoHumansMaleMiddle Aged

Identifiers

PMID24938303
PMCPMC4072900

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