Patient Navigation to Improve Cancer Screening in Underserved Populations: Reported Experiences, Opportunities, and Challenges

J Am Coll Radiol. 2018 Nov;15(11):1565-1572. doi: 10.1016/j.jacr.2018.03.001. Epub 2018 Apr 21.


Our goal is to define patient navigation for an imaging audience, present a focused selection of published experiences with navigation programs for breast and colorectal cancer screening, and expose principal barriers to the success of such programs. Despite numerous advances in the early detection of cancers, many patients still present with advanced disease. A disproportionate number are low-income minority patients who experience worse health outcomes than their white or more financially stable counterparts. Patient navigation, which aims to assist the medically underserved by overcoming specific barriers to care, may represent one solution to narrowing disparities. Related research suggests that in general, patient navigation programs that have addressed breast or colorectal cancer screening have been successful in improving screening rates and timeliness of follow-up care. However, although beneficial, navigation is expensive and may present an unmanageable financial burden for many health care centers. To overcome this challenge, navigation efforts will likely need to target those patients that are most likely to benefit. Further research to identify such patients will be critically important for improving the sustainability of navigation programs, and, in turn, for realizing the benefits of such programs in reducing cancer disparities.

Keywords: Patient navigation; breast cancer; cancer care; colorectal cancer; disparities.

Publication types

  • Review

MeSH terms

  • Breast Neoplasms / diagnostic imaging*
  • Colorectal Neoplasms / diagnostic imaging*
  • Early Detection of Cancer
  • Female
  • Health Services Accessibility
  • Healthcare Disparities
  • Humans
  • Male
  • Mass Screening / standards*
  • Medically Underserved Area*
  • Minority Groups*
  • Patient Navigation*
  • Poverty*
  • Quality Improvement*