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Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature |
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| Authors: | Raymond J Chan RN PhD Vivienne E Milch MBBS |
| Institution: | 1. Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia;2. Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
Cancer Australia, Sydney, New South Wales, Australia School of Medicine, The University of Notre Dame Australia, Sydney, New South Wales, Australia;3. Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia Institute of Health and Wellbeing, Federation University Australia, Ballarat, Victoria, Australia;4. Cancer Australia, Sydney, New South Wales, Australia National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia;5. Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA;6. Cancer Australia, Sydney, New South Wales, Australia;7. Cancer Australia, Sydney, New South Wales, Australia School of Medicine, University of Adelaide, Adelaide, South Australia, Australia |
| Abstract: | Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify, critically appraise, synthesize, and present the best available evidence to inform policy and planning regarding patient navigation across the cancer continuum. Systematic reviews examining navigation in cancer care were identified in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), Epistemonikos, and Prospective Register of Systematic Reviews (PROSPERO) databases and in the gray literature from January 1, 2012, to April 19, 2022. Data were screened, extracted, and appraised independently by two authors. The JBI Critical Appraisal Checklist for Systematic Review and Research Syntheses was used for quality appraisal. Emerging literature up to May 25, 2022, was also explored to capture primary research published beyond the coverage of included systematic reviews. Of the 2062 unique records identified, 61 systematic reviews were included. Fifty-four reviews were quantitative or mixed-methods reviews, reporting on the effectiveness of cancer patient navigation, including 12 reviews reporting costs or cost-effectiveness outcomes. Seven qualitative reviews explored navigation needs, barriers, and experiences. In addition, 53 primary studies published since 2021 were included. Patient navigation is effective in improving participation in cancer screening and reducing the time from screening to diagnosis and from diagnosis to treatment initiation. Emerging evidence suggests that patient navigation improves quality of life and patient satisfaction with care in the survivorship phase and reduces hospital readmission in the active treatment and survivorship care phases. Palliative care data were extremely limited. Economic evaluations from the United States suggest the potential cost-effectiveness of navigation in screening programs. |
| Keywords: | cancer navigation early detection oncology navigation patient navigation screening survivorship treatment |