title: Impact of patient and navigator race and language concordance on care after cancer screening abnormalities.
abstract: BACKGROUND
  Patient navigation improves the timely diagnosis of cancer among minorities, but little is known about the effects of patient and navigator race and language concordance on health outcomes.
  
  
  METHODS
  The authors investigated the effects of patient and navigator race and language concordance on the time to diagnosis of cancer screening abnormalities among participants in the Boston Patient Navigation Research Program, a clinical effectiveness trial for women who had breast or cervical cancer screening abnormalities identified from January 1, 2007 to December 31, 2008. Hazard ratios and 95% confidence intervals were estimated using proportional hazards regression adjusting for clinical and demographic factors.
  
  
  RESULTS
  In total, 1257 women had breast cancer screening abnormalities (n = 655) or cervical cancer screening abnormalities (n = 602) identified, and 56% were nonwhite. Language concordance was associated with timelier resolution for all patients in the cervical cancer screening abnormalities group during the first 90 days (adjusted hazard ratio, 1.46; 95% confidence interval, 1.18-1.80), and specifically for Spanish speakers during the first 90 days (adjusted hazard ratio, 1.43; 95% confidence interval, 1.10-1.84), but no difference was observed after 90 days for women who had cervical cancer screening abnormalities or at any time for those who had breast cancer screening abnormalities. Race concordance was associated with significant decreases in the time to diagnosis for minority women with breast and cervical cancer screening abnormalities in analyses stratified by race, but no differences were observed in analyses that included all women.
  
  
  CONCLUSIONS
  Patient navigator race and language concordance improved the timeliness of care in a minority population. Patient navigators who are racially/ethnically diverse and multilingual may help address barriers to care and improve cancer outcomes for low-income minorities.
authors.affiliation: Section of Hematology/Oncology, Department of Medicine, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Marjory
authors.initials: M
authors.lastname: Charlot
authors.forename: M Christina
authors.initials: MC
authors.lastname: Santana
authors.forename: Clara A
authors.initials: CA
authors.lastname: Chen
authors.forename: Sharon
authors.initials: S
authors.lastname: Bak
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Heeren
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Battaglia
authors.forename: A Patrick
authors.initials: AP
authors.lastname: Egan
authors.forename: Richard
authors.initials: R
authors.lastname: Kalish
authors.forename: Karen M
authors.initials: KM
authors.lastname: Freund
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People; D001943:Breast Neoplasms / Q000175:diagnosis / Q000628:therapy*; D055088:Early Detection of Cancer; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D008875:Middle Aged; D015999:Multivariate Analysis; D062526:Patient Navigation; D016016:Proportional Hazards Models; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult
keywords: cancer screening; disparities; language; patient navigator; race