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Colorectal Cancer Screening Navigation for the Underserved: Experience of an Urban Program
Alicia Lamanna1, Heather Sheaffer1, Carmen Guerra1
1Ms Lamanna is the patient navigator for the West Philadelphia GI Outreach program in the Abramson Cancer Center of Penn Medicine in Philadelphia, Pennsylvania and is affiliated with the Gastroenterology Division of Penn Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania. Dr Sheaffer is director of patient and family services at the Abramson Cancer Center. Dr Guerra is codirector of the West Philadelphia GI Outreach program; associate chief of staff at the Abramson Cancer Center; associate professor of medicine in the Division of General Internal Medicine at the Perelman School of Medicine at the University of Pennsylvania; and the current president of the board for the East Central Division of the American Cancer Society. Dr Kochman is codirector of the West Philadelphia GI Outreach program; Wilmott Family Professor of Medicine; director of the Center for Endoscopic Innovation, Research, and Training; and development officer for the Department of Medicine at Penn Medicine.
A navigation program improved colorectal cancer screening rates in underserved urban populations by addressing barriers like transportation and lack of awareness. This initiative enhances access to essential colon cancer screenings for at-risk individuals.
Area of Science:
- Public Health
- Cancer Prevention
- Health Disparities
Background:
- Colorectal cancer is a leading cause of cancer deaths in the U.S.
- Screening rates remain suboptimal, particularly in inner-city populations.
- Existing guidelines recommend regular colorectal cancer screening for adults aged 50-75.
Purpose of the Study:
- To address low colorectal cancer screening rates in underserved urban areas.
- To increase access to colorectal cancer screening colonoscopies.
- To overcome barriers hindering screening adherence.
Main Methods:
- Implementation of a patient navigation program by the University of Pennsylvania Health System.
- Targeting patients due for screening, never scheduled, or non-adherent.
- Providing free education and one-on-one navigation from initial contact to colonoscopy completion.
Main Results:
- The navigation program aimed to improve adherence by addressing identified barriers.
- Barriers included lack of a companion, poor awareness, fear, cost of preparation materials, comprehension issues, and scheduling difficulties.
- The program focused on cost-effective navigation to reach non-adherent patients.
Conclusions:
- Patient navigation is a viable strategy to increase colorectal cancer screening in underserved populations.
- Addressing specific patient barriers is crucial for improving screening uptake.
- Targeted interventions can mitigate health disparities in cancer screening.
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