Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature

Raymond J. Chan, Vivienne E. Milch, Fiona Crawford-Williams, Oluwaseyifunmi Andi Agbejule, Ria Joseph, Jolyn Johal, Narayanee Dick, Matthew P. Wallen, Julie Ratcliffe, Anupriya Agarwal, Larissa Nekhlyudov, Matthew Tieu, Manaf Al-Momani, Scott Turnbull, Rahul Sathiaraj, Dorothy Keefe, Nicolas H. Hart

Research output: Contribution to journalReview articlepeer-review

37 Citations (Scopus)
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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.

Original languageEnglish
Pages (from-to)565-589
Number of pages25
JournalCA Cancer Journal for Clinicians
Volume73
Issue number6
Early online date26 Jun 2023
DOIs
Publication statusPublished - 1 Nov 2023

Keywords

  • cancer navigation
  • early detection
  • oncology navigation
  • patient navigation
  • screening
  • survivorship
  • treatment

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