大規模地域ベースの大腸がんスクリーニングプログラムにおける患者ナビゲーション活動

Colorectal cancer (CRC) screening is recommended for average-risk individuals aged 45-75 years old; however, screening rates are suboptimal. An evidence-based strategy found to be effective at increasing screening uptake is patient navigation. The purpose of this paper is to describe patient navigation activities delivered in an effective culturally tailored community-based colorectal cancer screening program in an unscreened, underserved and predominantly Hispanic population.

A total of 690 participants recruited between March 2012 and January 2015 were eligible to receive a colonoscopy. A random sample of 100 high-risk participants and 100 participants who had a positive FIT test were selected for inclusion. We characterized participant identified barriers, navigation contact types, frequency and duration. Linear and logistic regression models were used to examine associations between sociodemographic and health-related factors and two outcomes: (1) the number of navigation activities participants required, and (2) whether participants reported experiencing at least one barrier to screening.

The average age of participants in our sample was 56.3 years (SD = 5.72), with the majority being female (74.0%) and Hispanic (96.5%). On average, participants received 9.66 navigation contacts in the program, and navigators spent 54.89 min per participant delivering navigation services. The most common activities identified were scheduling appointments, reminder phone calls, and communicating results.

These results provide detailed information about type and duration of navigation activities for CRC screening and colonoscopy completion within an effective community-based CRC screening program designed for and underserved and underscreened population.