Use of a patient navigator to increase colorectal cancer screening in an urban neighborhood health clinic

J Urban Health. 2005 Jun;82(2):216-24. doi: 10.1093/jurban/jti046. Epub 2005 May 11.


Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Racial disparities in CRC incidence and mortality have been well documented. In addition, lower rates of CRC screening among ethnic minorities have been reported. Therefore, we tested the effectiveness of a patient navigator (PN) in increasing compliance with CRC screening in a minority community health setting. Men and women aged 50 or older attending a primary care practice were enrolled if they had not had a fecal occult blood test within the past year, a sigmoidoscopy or barium enema within the past 3-5 years, or a colonoscopy within the past 10 years. Participants were randomly assigned either to receive navigator services (PN+) or not to receive navigator services (PN-). There were no demographic differences between the two groups. Within 6 months of physician recommendation, 15.8% in the PN+group had complied with an endoscopic examination, compared with only 5% in the PN - group (P=.019). The PN+group also demonstrated higher rates of fecal occult blood test completion (42.1% vs. 25%, P=.086). Thus, a PN system successfully increases CRC screening rates among a predominantly minority population of low socioeconomic status.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Colonoscopy / statistics & numerical data*
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / ethnology
  • Community Health Centers*
  • Diagnostic Tests, Routine / statistics & numerical data
  • Female
  • Health Services Accessibility
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • New York City
  • Occult Blood
  • Patient Acceptance of Health Care / ethnology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Education as Topic*
  • Physician-Patient Relations
  • Sigmoidoscopy / statistics & numerical data*
  • Socioeconomic Factors
  • Urban Health Services*