Impact of Patient Navigation on Population-Based Breast Screening: a Systematic Review and Meta-analysis of Randomized Clinical Trials

J Gen Intern Med. 2022 Aug;37(11):2811-2820. doi: 10.1007/s11606-022-07641-y. Epub 2022 Jun 1.

Abstract

Background: Unsatisfactory cancer screening results are often associated with poor prognosis. This study synthesized the literatures addressing the impact of patient navigation (PN) interventions on population-based breast cancer screening promotion to identify characteristics of the model for addressing breast cancer disparities.

Methods: We searched Pubmed, Embase, Web of Science, and the Cochrane Central Registry from inception to 31 December 2020 for randomized controlled trials (PROSPERO: CRD42021246890). We double blindly abstracted data and assessed study quality. We assessed screening completion rates and diagnostic resolution using random-effects models between those receiving navigation and controls.

Results: Of 236 abstracts identified, 15 studies met inclusion criteria. Nine of the papers evaluated the impact of PN on breast screening, while the other six were on the resolution of abnormal screening results. Compared to the non-PN group, PN improved screening completion (OR: 2.0, 95% CI: 1.4-2.8]) and shortened the time to diagnosis (WMD: - 9.90 days, 95% CI: - 19.09 to - 0.71).

Conclusions: Patient navigation improves breast cancer screening rates but does not improve resolution of abnormal tests.

Keywords: barriers to care; early detection of cancer; health services research; patient navigation.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Neoplasms* / diagnosis
  • Early Detection of Cancer / methods
  • Female
  • Humans
  • Mass Screening
  • Patient Navigation* / methods
  • Randomized Controlled Trials as Topic