Connecting Patients with Clinical Trials Using Patient Navigation: A Scoping Review

Patient navigation is a promising intervention to address barriers and improve access to cancer clinical trials. Although navigation has been widely studied across the cancer continuum, its role in facilitating clinical trial participation has not been systematically evaluated. This scoping review aims to identify, characterize, and synthesize evidence on patient navigation interventions designed to increase access to cancer clinical trials. Nine databases were searched for English peer-reviewed articles from inception through 5 March 2025. Two independent researchers screened titles, abstracts, and full texts and extracted data using standardized forms. The results were interpreted using descriptive statistics and collated using predetermined conceptual frameworks. Of 10,238 citations identified, 23 studies met inclusion criteria. All were conducted in North America, and five (21.7%) were randomized controlled trials. Thirteen studies (56.5%) evaluated enrollment outcomes, with mixed results. One randomized trial and two observational studies found no significant effect, while three observational studies and seven single-arm reports suggested improved enrollment. Navigation interventions most commonly included education/information provision (100%), care coordination (60.9%), and empowerment (47.8%). Navigators were primarily lay navigators (73.9%), often selected for community or lived experience; training varied widely, and only two programs reported certification. Fifteen studies (65.2%) targeted equity-deserving groups, most frequently racial and ethnic minorities, with reports of increased representation in trial enrollment. Patient navigation shows promise in improving access to cancer clinical trials, particularly for equity-deserving populations, but current evidence is limited, heterogeneous, and largely observational. Standardized definitions, rigorous trial designs, and reporting of navigator training and outcomes are needed to clarify effectiveness.