Effectiveness of patient navigation for colorectal cancer screening: A systematic review and meta-analysis of randomized controlled trials
- Author:
Nikki Regine P. Pader
1
;
Anna Grace J. Mendoza
1
;
Rojim J. Sorrosa
1
Author Information
- Publication Type:Other Types
- MeSH: Colorectal Neoplasms; Patient Navigation
- From: The Filipino Family Physician 2022;60(1):144-158
- CountryPhilippines
- Language:English
-
Abstract:
Background:Colorectal cancer is highly preventable through early screening, but disparities in screening create a negative impact on the lives of those at risk. One approach to address this is patient navigation. This systematic review and meta-analysis therefore aimed to provide evidence of the effectiveness of patient navigation in increasing colorectal cancer screening uptake.
Objectives:This study aimed to determine the effectiveness of patient navigation on colorectal cancer screening uptake. Specifically, it aimed to study the effects of different methods of navigation on the uptake of initial screening tests among persons with average risk.
Methods:The studies included were randomized clinical trials conducted within 2011-2021 and involving only humans as participants. Data were analyzed by calculating the risk ratio and 95% confidence intervals of each successful outcome, and the investigators independently appraised each study’s risk of bias. Subgroup analysis was conducted to assess consistency of study effects. Certainty of evidence was assessed using the GRADE standard.
Results:Eleven (11) studies were included in this systematic review and meta-analysis. All studies encompassed health systems of different countries, and they utilized different means of navigation to achieve outcome measure of colorectal cancer screening uptake. Results show a statistically significant increase in screening uptake with patient navigation in a forest plot. However, there is a high level of heterogeneity among the studies, hence a subgroup analysis was conducted among these studies according to navigation method.
Conclusion:This systematic review and meta-analysis show an increase in screening rates in those who were navigated. Results in favor of patient navigation was consistent when all studies were analyzed together and when they were analyzed according to navigation method. Increase in screening uptake is more statistically significant among patients navigated via face-to-face and via phone call, but data is more consistent for patient navigation via phone call alone. - Full text:Filipino-Family-Physician-2022-60-pages-148-162.pdf
