TY - JOUR
T1 - Patient navigation across the cancer care continuum
T2 - An overview of systematic reviews and emerging literature
AU - Chan, Raymond J.
AU - Milch, Vivienne E.
AU - Crawford-Williams, Fiona
AU - Agbejule, Oluwaseyifunmi Andi
AU - Joseph, Ria
AU - Johal, Jolyn
AU - Dick, Narayanee
AU - Wallen, Matthew P.
AU - Ratcliffe, Julie
AU - Agarwal, Anupriya
AU - Nekhlyudov, Larissa
AU - Tieu, Matthew
AU - Al-Momani, Manaf
AU - Turnbull, Scott
AU - Sathiaraj, Rahul
AU - Keefe, Dorothy
AU - Hart, Nicolas H.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - 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.
AB - 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.
KW - cancer navigation
KW - early detection
KW - oncology navigation
KW - patient navigation
KW - screening
KW - survivorship
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85162995462&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1194051
UR - http://purl.org/au-research/grants/NHMRC/2017080
U2 - 10.3322/caac.21788
DO - 10.3322/caac.21788
M3 - Review article
AN - SCOPUS:85162995462
SN - 0007-9235
VL - 73
SP - 565
EP - 589
JO - CA Cancer Journal for Clinicians
JF - CA Cancer Journal for Clinicians
IS - 6
ER -
