ColoNav: patient navigation for colorectal cancer screening in deprived areas - Study protocol

C Allary, A Bourmaud, F Tinquaut, M Oriol, J Kalecinski, V Dutertre, N Lechopier, M Pommier, Y Benoist, S Rousseau, V Regnier, V Buthion, F Chauvin, C Allary, A Bourmaud, F Tinquaut, M Oriol, J Kalecinski, V Dutertre, N Lechopier, M Pommier, Y Benoist, S Rousseau, V Regnier, V Buthion, F Chauvin

Abstract

Background: The mass colorectal cancer screening program was implemented in 2008 in France, targeting 16 million French people aged between 50 and 74. The current adhesion is insufficient and the participation rate is even lower among the underserved population, increasing health inequalities within our health care system. Patient Navigation programs have proved their efficiency to promote the access to cancer screening and diagnosis.

Methods/design: The purpose of the study is to assess the implementation of a patient navigation intervention that has been described in another cultural environment and another health care system. The main objective of the program is to increase the colorectal cancer screening participation rate among the deprived population through the intervention of a navigator to promote the Fecal Occult Blood Test (FOBT) and complementary exams. We performed a multisite cluster randomized controlled trial, with three groups (one experimental group and two control groups) for 18 months.

Discussion: The study attempts to give a better understanding of the adhesion barriers to colorectal cancer screening among underserved populations. If this project is cost-effective, it could create a dynamic based on peer approaches that could be developed for other cancer screening programs and other chronic diseases.

Trial registration: NCT02369757.

Keywords: Colorectal cancer screening; Health inequalities; Implementation research; Patient navigation; Randomized control study; Realistic evaluation.

Figures

Fig. 1
Fig. 1
Conceptual model of patient navigation (Fiscella 2011)

References

    1. Ferlay, J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [online]. International Agency for Research on Cancer, Lyon (France) 2013. Available from .
    1. Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med. 1993;328(19):1365–71. doi: 10.1056/NEJM199305133281901.
    1. Kronborg O, Jorgensen OD, Fenger C, Rasmussen M. Randomized study of biennial screening with a faecal occult blood test: results after nine screening rounds. Scand J Gastroenterol. 2004;39(9):846–51. doi: 10.1080/00365520410003182.
    1. Hardcastle JD, Chamberlain JO, Robinson MH, et al. Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet. 1996;348(9040):1472–7. doi: 10.1016/S0140-6736(96)03386-7.
    1. Faivre J, Dancourt V, Lejeune C, et al. Reduction in colorectal cancer mortality by fecal occult blood screening in a French controlled study. Gastroenterology. 2004;126(7):1674–80. doi: 10.1053/j.gastro.2004.02.018.
    1. Hewitson P, Glasziou P, Watson E, et al. Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (hemoccult): an update. Am J Gastroenterol. 2008;103(6):1541–9. doi: 10.1111/j.1572-0241.2008.01875.x.
    1. Faivre J, Lepage C, Dancourt V. Le dépistage organisé du cancer colorectal en France et en Europe : historique et état des lieux. Numéro thématique – Dépistage organisé du cancer colorectal en France. Bull Epidemiol Hebdo. 2009;13:02–3.
    1. Von Euler-Chelpin M, Brasso K, Lynge E. Determinants of participation in colorectal cancer screening with faecal occult blood testing. J Public Health (Oxf) 2010;32:395–405. doi: 10.1093/pubmed/fdp115.
    1. Pornet C, Dejardin O, Morlais F, Bouvier V, Launoy G. Socioeconomic determinants for compliance to colorectal cancer screening. A multilevel analysis. J Epidemiol Community Health. 2010;64:318–24. doi: 10.1136/jech.2008.081117.
    1. Mackenbach JP, Stirbu I, Roskam AJ, Schaap MM, Menvielle G, Leinsalu M, Kunst AE. European Union Working Group on Socioeconomic Inequalities in Health. Socioeconomic inequalities in health in 22 European countries. N Engl J Med. 2008;358(23):2468–81. doi: 10.1056/NEJMsa0707519.
    1. Menvielle G, Kunst AE, Stirbu I, Strand BH, Borrell C, Regidor E, Leclerc A, Esnaola S, Bopp M, Lundberg O, Artnik B, Costa G, Deboosere P, Martikainen P, Mackenbach JP. Educational differences in cancer mortality among women and men: a gender pattern that differs across Europe. Br J Cancer. 2008;98(5):1012–9. doi: 10.1038/sj.bjc.6604274.
    1. Dohan D, Schrag D. Using navigators to improve care of underserved patients : current practices and approaches. Cancer. 2005;104(4):848–55. doi: 10.1002/cncr.21214.
    1. Wells KJ, Battaglia TA, Dudley DJ, Garcia R, Greene A, Calhoun E, Mandelblatt JS, Paskett ED, Raich PC. Raich PC; Patient Navigation Research Program. Patient navigation: state of the art or is it science? Cancer. 2008;113(8):1999–2010.
    1. Paskett ED, Harrop JP, Wells KJ. Patient navigation: an update on the state of the science. CA Cancer J Clin. 2011;61(4):237–49. doi: 10.3322/caac.20111.
    1. Freeman HP, Muth BJ, Kerner JF. Expanding access to cancer screening and clinical follow-up among the medically underserved. Cancer Pract. 1995;3:19–30.
    1. Freeman HP, Rodriguez RL. History and principles of patient navigation. Cancer. 2011;117(15 Suppl):3539–42.
    1. Nash D, Azeez S, Vlahov D, Schori M. Evaluation of an Intervention to Increase Screening Colonoscopy in an Urban Public Hospital Setting. J Urban Health. 2006;83(2):231–43. doi: 10.1007/s11524-006-9029-6.
    1. Jandorf L, Gutierrez Y, Lopez J, Christie J, Itzkowitz SH. Use of a Patient Navigator to Increase Colorectal Cancer Screening in an Urban Neighborhood Health Clinic. J Urban Health. 2005;82(2):216–24. doi: 10.1093/jurban/jti046.
    1. Natale-Pereira A, Enard KR, Nevarez L, Jones LA. The role of patient navigators in eliminating health disparities. Cancer. 2011;117(15 Suppl):3543–52.
    1. Lorhan S, Cleghom L, Fitch M, Pang K, McAndrew A, Applin-Poole J, Ledwell E, Mitchell R, Wright M. Moving the agenda forward for cancer patient navigation: understanding volunteer and peer navigation approaches. J Cancer Educ. 2013;28(1):84–91. doi: 10.1007/s13187-012-0424-2.
    1. Fang CY, Ma GX, Tan Y, Chi N. A multifaceted intervention to increase cervical cancer screening among Korean women. Cancer Epidemiol Biomarkers Prev. 2007;16(6):1298–302. doi: 10.1158/1055-9965.EPI-07-0091.
    1. Ma GX, Yin L, Gao W, Tan Y, Liu R, Fang C, Ma XS. Workplace-based breast cancer screening intervention in China. Cancer Epidemiol Biomarkers Prev. 2012;21(2):358–67. doi: 10.1158/1055-9965.EPI-11-0915.
    1. Pornet C, Delapierre C, Dejardin O, Grosclaude P, Launay L, Guittet L, Lang T, Launoy G. Construction of an adaptable European transnational ecological deprivation index : The French version. J Epidemiol Community Health. 2012;66(11):982–9. doi: 10.1136/jech-2011-200311.
    1. Hayes RJ, Bennett S. Simple sample size calculation for cluster-randomized trials. Int J Epidemiol. 1999;28(2):319–26. doi: 10.1093/ije/28.2.319.
    1. Jean-Pierre P, Hendren S, Fiscella K, Loader S, Rousseau S, Schwartzbauer B, et al. Understanding the processes of patient navigation to reduce disparities in cancer care: perspectives of trained navigators from the field. J Cancer Educ. 2011;26(1):111–20.
    1. Pawson R, Tilley N. Realistic Evaluation, Sage, 1997.
    1. Connelly JB. Evaluating complex public health interventions: theory, methods and scope of realist enquiry. J Eval Clin Pract. 2007;13(6):935–41.
    1. Battaglia TA, Burhansstipanov L, Murrell SS, Dwyer AJ. Caron SE. Prevention and Early Detection Workgroup, National Patient Navigation Leadership Summit. Assessing the impact of patient navigation: prevention and early detection metrics. Cancer. 2011;117(15 Suppl):3553–64.
    1. Fiscella K, Ransom S, Jean-Pierre P, Cella D, Stein K, Bauer JE, et al. Patient-reported outcome measures suitable to assessment of patient navigation. Cancer. 2011;117(15):3603–17.
    1. Whitley E, Valverde P, Wells K, Williams L, Teschner T, Shih YC. Establishing common cost measures to evaluate the economic value of patient navigation programs. Cancer. 2011;117(15 Suppl):3618–25.
    1. Creswell JW, Hanson WE, Clark Plano VL, Morales A. Qualitative Research Designs Selection and Implementation. Couns Psychol. 2007;35:236–64.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj