Personal navigation increases colorectal cancer screening uptake.

Area of Science:

• Public Health
• Preventive Medicine
• Health Services Research

Background:

• Prior randomized controlled trials (RCTs) suggest patient navigation improves colorectal cancer screening rates.
• Limited pragmatic trial data exists on interventions to enhance colorectal cancer screening adherence.
• This study evaluated a patient navigation intervention supporting preferred screening tests (colonoscopy or stool blood testing).

Purpose of the Study:

• To assess the impact of a patient navigation intervention on colorectal cancer screening adherence.
• To determine if supporting patients' preferred screening methods enhances screening uptake.
• To evaluate the effectiveness of patient navigation in a real-world primary care setting.

Main Methods:

• A pragmatic randomized controlled trial involving 5,240 primary care patients aged 50-74.
• Patients were randomized to either a nurse navigator intervention group or a usual care control group.
• The intervention involved nurse navigators discussing screening options and assisting with test arrangements; usual care served as the control.

Main Results:

• Colorectal cancer screening adherence was significantly higher in the intervention group (35%) compared to the control group (20%).
• The odds ratio for screening adherence in the intervention group was 2.11 (95% CI: 1.87-2.39).
• The intervention demonstrated a statistically significant increase in screening uptake.

Conclusions:

• Preference-based patient navigation effectively increased colorectal cancer screening uptake in a pragmatic randomized controlled trial.
• The observed increase in screening rates was comparable to findings from explanatory RCTs.
• Patient navigation is a viable strategy to improve colorectal cancer screening adherence in primary care.