Patient navigators might reduce disparities in cancer care

Past research shows that minorities suffer higher rates of advanced cancer and deaths from all types of cancer compared to whites. According to an article in the August issue of Cancer, the role of “patient navigator” is emerging as a tool to address these disparities.

Patient navigators work in their communities to help with known barriers to equal care such as financial and insurance issues, cultural and language differences and communication with health care providers. They also assist in educating the underserved population about preventive healthy lifestyles.

“Many of the large cancer centers – and a growing number of smaller, community-based cancer centers – have established programs to assist patients in navigating the cancer care continuum,” said report author Kimberly Enard, Ph.D., of the Center for Research on Minority Health at the University of Texas MD Anderson Cancer Center.

What is newer, Enard added, is the development of standardized metrics to measure the effectiveness of these programs, particularly in terms of health outcomes, patient satisfaction, quality of life and overall costs.

The authors detail how patient navigators can influence the type of cancer care that minorities receive. For instance, navigators can increase the likelihood that minorities get proper screenings, have insurance coverage and receive exercise and nutrition counseling, and they can reduce the differences between cancer rates by race and ethnicity.

“The jury is still out whether patient navigation is the answer to eliminating cancer health disparities,” cautioned Clement Gwede, Ph.D., associate director of diversity at the Moffitt Cancer Center in Tampa. “At this point, it is a great working hypothesis, but evidence is slowly accumulating. At Moffitt, patient navigation programs are few, limited and early – to where I don’t believe we can evaluate impact.”

Gwede added, however, that enthusiasm is high while the community awaits evidence that the programs are effective.

The American Cancer Society has made eliminating cancer health disparities by 2015 a priority and the government’s Healthy People 2010 has set similar goals.

“It’s too early to tell the impact, but the inputs are encouraging in the form of these increased funding efforts,” Gwede said. “Minority and socioeconomically underserved individuals will require great attention before we see improvements.”