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Relation of comorbidities and patient navigation with the time to diagnostic resolution after abnormal cancer screening.

Publication ,  Journal Article
Whitley, EM; Raich, PC; Dudley, DJ; Freund, KM; Paskett, ED; Patierno, SR; Simon, M; Warren-Mears, V; Snyder, FR ...
Published in: Cancer
January 1, 2017

BACKGROUND: Whether patient navigation improves outcomes for patients with comorbidities is unknown. The aims of this study were to determine the effect of comorbidities on the time to diagnostic resolution after an abnormal cancer screening test and to examine whether patient navigation improves the timeliness and likelihood of diagnostic resolution for patients with comorbidities in comparison with no navigation. METHODS: A secondary analysis of comorbidity data collected by Patient Navigation Research Program sites using the Charlson Comorbidity Index (CCI) was conducted. The participants were 6,349 patients with abnormal breast, cervical, colon, or prostate cancer screening tests between 2007 and 2011. The intervention was patient navigation or usual care. The CCI data were highly skewed across projects and cancer sites, and the CCI scores were categorized as 0 (CCI score of 0 or no comorbidities identified; 76% of cases); 1 (CCI score of 1; 16% of cases), or 2 (CCI score ≥ 2; 8% of cases). Separate adjusted hazard ratios for each site and cancer type were obtained, and then they were pooled with a meta-analysis random effects methodology. RESULTS: Patients with a CCI score ≥ 2 had delayed diagnostic resolution after an abnormal cancer screening test in comparison with those with no comorbidities. Patient navigation reduced delays in diagnostic resolution, with the greatest benefits seen for those with a CCI score ≥ 2. CONCLUSIONS: Persons with a CCI score ≥ 2 experienced significant delays in timely diagnostic care in comparison with patients without comorbidities. Patient navigation was effective in reducing delays in diagnostic resolution among those with CCI scores > 1. Cancer 2017;123:312-318. © 2016 American Cancer Society.

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Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

January 1, 2017

Volume

123

Issue

2

Start / End Page

312 / 318

Location

United States

Related Subject Headings

  • Time Factors
  • Proportional Hazards Models
  • Patient Navigation
  • Oncology & Carcinogenesis
  • Neoplasms
  • Middle Aged
  • Male
  • Humans
  • Healthcare Disparities
  • Female
 

Citation

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Whitley, E. M., Raich, P. C., Dudley, D. J., Freund, K. M., Paskett, E. D., Patierno, S. R., … Patient Navigation Research Program Investigators, . (2017). Relation of comorbidities and patient navigation with the time to diagnostic resolution after abnormal cancer screening. Cancer, 123(2), 312–318. https://doi.org/10.1002/cncr.30316
Whitley, Elizabeth M., Peter C. Raich, Donald J. Dudley, Karen M. Freund, Electra D. Paskett, Steven R. Patierno, Melissa Simon, Victoria Warren-Mears, Frederick R. Snyder, and Frederick R. Patient Navigation Research Program Investigators. “Relation of comorbidities and patient navigation with the time to diagnostic resolution after abnormal cancer screening.Cancer 123, no. 2 (January 1, 2017): 312–18. https://doi.org/10.1002/cncr.30316.
Whitley EM, Raich PC, Dudley DJ, Freund KM, Paskett ED, Patierno SR, et al. Relation of comorbidities and patient navigation with the time to diagnostic resolution after abnormal cancer screening. Cancer. 2017 Jan 1;123(2):312–8.
Whitley, Elizabeth M., et al. “Relation of comorbidities and patient navigation with the time to diagnostic resolution after abnormal cancer screening.Cancer, vol. 123, no. 2, Jan. 2017, pp. 312–18. Pubmed, doi:10.1002/cncr.30316.
Whitley EM, Raich PC, Dudley DJ, Freund KM, Paskett ED, Patierno SR, Simon M, Warren-Mears V, Snyder FR, Patient Navigation Research Program Investigators. Relation of comorbidities and patient navigation with the time to diagnostic resolution after abnormal cancer screening. Cancer. 2017 Jan 1;123(2):312–318.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

January 1, 2017

Volume

123

Issue

2

Start / End Page

312 / 318

Location

United States

Related Subject Headings

  • Time Factors
  • Proportional Hazards Models
  • Patient Navigation
  • Oncology & Carcinogenesis
  • Neoplasms
  • Middle Aged
  • Male
  • Humans
  • Healthcare Disparities
  • Female