Personal Navigation Increases Colorectal Cancer Screening Uptake
Menée au Canada auprès de 5 240 patients de médecins généralistes (âge : 50-74 ans), cette étude cas-témoins analyse l'efficacité d'une intervention par une infirmière coordinatrice pour améliorer leur participation au dépistage du cancer colorectal
Background: Prior randomized, controlled trials (RCTs) indicate patient navigation can boost colorectal cancer (CRC) screening in primary care. The sparse literature on pragmatic trials of interventions designed to increase CRC screening adherence motivated this trial on the impact of a patient navigation intervention that included support for performance of the participants' preferred screening test (colonoscopy or stool blood testing). Methods:Primary-care patients (n = 5240), 50-74 years of age, with no prior diagnosis of bowel cancer, and no record of a recent CRC screening test were identified at the Group Health Centre in northern Ontario. These patients were randomly assigned to an Intervention Group (N = 2629) or a usual care Control Group (N = 2611). Intervention Group participants were contacted by a trained nurse navigator by telephone to discuss CRC screening. Interested patients met with the navigator, who helped them identify and arrange for performance of the preferred screening test. Multivariate analyses were conducted using medical records data to assess intervention impact on screening adherence within 12 months after randomization. Results: Mean patient age was 59 years, and 50% of participants were women. CRC screening adherence was higher in the Intervention Group (35%) compared to the Control Group (20%), a difference that was statistically significant (OR-2.11, CI: 1.87 - 2.39). Conclusions: Preference-based patient navigation increased screening uptake in a pragmatic RCT. Impact: Patient navigation increased CRC screening rates in a pragmatic RCT in proportions similar to those observed in explanatory RCTs.