Improving cancer care for American Indians with cervical cancer in the Indian Health Service (IHS) system - Navigation may not be enough
| Autor: | Anita Motwani, L.E. Dockery, Laura L. Holman, Kathleen N. Moore, Kai Ding, Mark P. Doescher, Justin D. Dvorak |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Uterine Cervical Neoplasms Tertiary care 03 medical and health sciences Health services Young Adult 0302 clinical medicine Survivorship curve Internal medicine medicine Humans Patient Navigation 030212 general & internal medicine Young adult Aged Retrospective Studies Cervical cancer Aged 80 and over business.industry Obstetrics and Gynecology Cancer Retrospective cohort study Middle Aged medicine.disease United States Oncology 030220 oncology & carcinogenesis Cohort United States Indian Health Service Indians North American Patient Compliance Female business |
| Zdroj: | Gynecologic oncology. 149(1) |
| ISSN: | 1095-6859 |
| Popis: | Objectives Patient navigation programs have been shown to positively impact cancer outcomes for minority populations. Little is known regarding the effects of these programs on American Indian (AI) populations. The purpose of this study is to characterize the impact of a patient navigation program on AI cervical cancer patients at a tertiary care center. Methods A retrospective review of all AI cervical cancer patients receiving navigation services and a cohort of AI patients treated prior to navigation services was performed. Additional comparisons were made between those with and without Indian Health Service (IHS) funding. Summary statistics were used to describe demographic, clinical characteristics, treatment, and survivorship across groups. Results Of 55 patients identified, 34 received navigation and 21 did not. In navigated patients, median age was 46years (27–80years) compared with 42years (17–68years) in pre-navigation patients ( p =0.53). There was no difference between stage at diagnosis ( p =0.73). No difference was noted in treatment received between groups ( p =0.48). Distance traveled for treatment between groups did not differ ( p =0.46). Median time to initiation of treatment was not different between groups, 30.5days vs. 27.5days ( p =0.18). Among patients with IHS funding, navigation services did not alter time to initiation of treatment ( p =0.57), and there was no difference in completion of prescribed therapy between groups (92% navigated vs 100% pre-navigation). Conclusions Navigation services for AI cervical cancer patients did not alter initiation or completion of treatment. Navigation programs may provide less tangible benefits to AI cervical cancer patients and further study is warranted. |
| Databáze: | OpenAIRE |
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