Navigating Latinas with breast cancer to treatment: The six cities study

Breast cancer is the leading cause of cancer deaths in Latinas. Time from cancer diagnosis to treatment initiation is critical in optimizing care. Patient navigation (PN) is a potentially effective means of promoting timely breast cancer treatment, yet efficacy is insufficiently documented.

Redes En Acción: The National Latino Cancer Research Network, tested the effects of a theory-driven, culturally-sensitive PN program for Latinas with breast cancer in six U.S. cities. We evaluated time from diagnosis to initial treatment and proportions of women treated within 30 days of diagnosis.

We analyzed 109 Latinas diagnosed with breast cancer from July 2008-January 2011 (42 navigated, 67 controls). Women were navigated by locally trained navigators, or non-navigated. Kaplan-Meier, Cox proportional hazards, and logistic regression models were used to determine group differences.

Time from cancer diagnosis to first treatment was lower in the navigated group (mean 24.98 days, control 38.12 days, HR 1.61, p=0.02). Additionally, 64.3% of navigated Latinas began treatment within 30 days of cancer diagnosis, vs. 47.8% of non-navigated Latinas (p=0.015). These results were independent of stage at diagnosis and cancer clinic and participant characteristics. Examination of navigator logbooks indicated that faster treatment times likely resulted from at least three activities: oncology appointment reminders, transportation and/or accompaniment to appointments, and translation services.

Patient-centered navigation to assist Latina women with breast cancer diagnoses significantly reduces time from diagnosis to treatment, and increases the proportion of women beginning treatment within 30 days of diagnosis. Improvement appears to be associated with specific navigator activities.