title: Expanding access to cancer screening and clinical follow-up among the medically underserved.
abstract: Blacks have the highest cancer incidences and mortality rates in the United States. Higher mortality rates appear due to higher incidence in some sites and to later-stage diagnoses in others. To address these problems, expanded cancer screening in an inner-city public hospital and a patient navigator intervention were proposed. Patient navigators acted as patient advocates for patients with abnormal screening findings. One thousand thirty-four females and 102 males were screened from July 1990 through November 1992; seven breast cancers and one cervical cancer were found. Patient navigators were significantly more likely to have seen patients with suspicious findings than patients with non-suspicious findings. However, even among those with suspicious findings, almost 70% were not seen by a patient navigator. Of those navigated, 87.5% completed recommended breast biopsies, compared with 56.6% of the non-navigated patients. Among those with a biopsy, navigated patients did so in significantly less time than those not navigated. Navigation is one of three phases proposed to reduce cancer mortality among medically underserved populations.
authors.forename: H P
authors.initials: HP
authors.lastname: Freeman
authors.forename: B J
authors.initials: BJ
authors.lastname: Muth
authors.forename: J F
authors.initials: JF
authors.lastname: Kerner
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control*; D010344:Patient Advocacy; D014504:Urban Health