1. Abstract
How Does Patient Navigator Work?
Tools to Assist Health Providers
Citations
Jason Sims BSN RN SGNA Fellow Melinda Beatty MSN,BSN, RN
Department of Gastroenterology, Henry Ford Health System, Detroit, Michigan
Increasing Colon Cancer Screening Rates Among African American Males
According to the American Cancer Society 2016-2018 report of Cancer Facts and Figures for African Americans an
estimated 17,240 cases of colorectal cancer are expected to occur among blacks in 2016. Colorectal cancer is the third
most common cancer in black men. The most effective way of tackling this disease is through early detection by way of
colon rectal cancer screening. The reasons for non compliance can be traced to a lack of colon cancer knowledge,
socioeconomic status and lack of encouragement from primary care physicians regarding the importance of early
detection. What this educational poster will attempt to do is to provide healthcare workers with the tools and strategies
to teach and increase knowledge of colon cancer and the importance of screening as well as minimizing barriers to
screening.3
“What’s Going On?”
Study done by Murff Md,MPH et al found that African Americans with a strong family history of colon
cancer were less likely to undergo CRC screening than white counterparts with the similar family histories.
African Americans are more likely to report lack of recommendations for CRC screening by health care
providers.1
African American men not only have lesser rates of CRC screening but
when they are diagnosed they also die at a quicker rate4
According to a study done by Bastani et al, African Americans with a family
history are less likely to perceive themselves with having increased risk for
disease
Catching colon cancer before advanced stage of disease onset is essential4
• African Americans have higher incidence of co-morbid illnesses like diabetes mellitus that
lead to increased chances of CRC5
• Higher obesity rates in African American men, 37% vs 25% of Non-Hispanic whites in
2009, a CRC factor6
• African American and White males with less than a high school education have more than
twice the cancer death rate than those who are college educated3
•
• Low educational attainment is related to low health literacy which leads to:
– Misunderstanding of care and follow up treatment
– Developing and maintaining attitudes and beliefs that contradict recommended
treatment
– Unrealistic fears about recommended therapy12
• Low SES lead to barriers to CRC screening
– Transportation issues
– Unable to take time off of work along with child care arrangements
– Misunderstanding directions for care and follow up7
Target entire community
Provide individualized counseling based on SES in the community
Train physicians how to counsel patients during office visits based on individual
circumstances13Patient Navigator
• Created by Dr. Harold Freeman in 1990 to facilitate cancer screening and care for poor individuals
living in medically underserved communities
• Superior to conventional methods
• Consisting of case managers and people in the community along with the organizational structure of
specific oncology practices, hospitals and other institutions8
• Identify the patients unique logistical and emotional needs
• Anticipation and development of effective solutions to present and unforeseen barriers
• Facilitating communication between patients and providers
• Assisting in getting to and preparation for appointments
• Utilization of community and social services
• Providing health education 8
“Catch a Killer: Get Screened for Colon Cancer”
https://www.youtube.com/watch?feature=player_embedded&v=hoLF8YM2wG4
Starring CSI:NY actor Hill Harper. The PSA reminds African-Americans to get screened for colon
cancer. Guidelines suggest that those at average risk begin screening at age 50, however, some studies
have shown that African-Americans are more frequently diagnosed with colon cancer at a younger
age, leading some experts to suggest that African-Americans should begin screening at age 45.
Cancer and the African American Experience
http://www.youtube.com/watch?v=wgaZvhW4M5U
GET CREATIVE!!!
1.Harvey J. Murff, MD, MPH; Neeraja B. Peterson, MD, MSc; Jay H. Fowke, PhD, MPH; Margaret Hargreaves, PhD; Lisa B. Signorello, ScD; Robert S. Dittus, MD, MPH;
Wei Zheng, MD, PhD; William J. Blot, PhD. Colonoscopy Screening in African Americans and Whites With Affected First-Degree Relatives. Arch Intern Med.
2008;168(6):625-631. doi:10.1001/archinte.168.6.625.
2.Lisa B. Signorello, Margaret K. Hargreaves, Mark D. Steinwandel, Wei Zheng, Qiuyin Cai, David G. Schlundt, Maciej S. Buchowski, Carolyne W. Arnold,
Joseph K. McLaughlin, and William J. Blot Southern community cohort study: establishing a cohort to investigate health disparities. J Natl Med Assoc. 2005 Jul; 97(7):
972–979 (Table 2 and Table 5)
3.http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-047403.pdf
4.Bastani,R Gallardo,NV Maxwell,AE. Barriers to colorectal cancer screening among ethnically diverse high- and average-risk individuals. J Psych Oncol 2001;19
(3/4) 65- 83
5. Nagel G, Wedding U, Hoyer H, et al. The impact of comorbidity on the survival of postmenopausal women with breast cancer. J Cancer Res Clin Oncol.
2004;130:664-670
6. Sherry B, Blanck HM, Galuska DA, et al. Vital Signs: State-specific obesity prevalence among adults --- United States, 2009. Centers for Disease Control and
Prevention Morbidity and Mortality Weekly Report (MMWR). August 3, 2010/59 (Early Release);1-5.
7. Scheppers E, van Dongen E, Dekker J, et al. Potential barriers to the use of health services among ethnic minorities: a review. Family Practice. 2006;23:325-348.
8. 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.
9. Education in Palliative and End-of-Life Care for Oncology: Cultural Considerations When Caring for African Americans Plenary AA:Cancer and the African
American Experience
10. http://www.screenforcoloncancer.org/physicianResources.asp
11. Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA
(eds). SEER Cancer Statistics Review, 1975-2012, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2012/
12. Medical Expenditure Panel Survey 2008. Table 1: Usual Source of Health Care and Selected Population Characteristics, United States, 2008.
13. Stephanie H. Ward, MD, MPH; Karen Lin, MD, MPH; Brian Meyer, MD, MPH; Sarah B. Bass, PhD, MPH; Lalitha Parameswaran, MBBS, MPH; Thomas F. Gordon,
PhD; and Sheryl Burt Ruzek, PhD, MPH Increasing Colorectal Cancer Screening among African Americans, Linking Risk Perception to Interventions Targeting
Patients,
Communities and Clinicians JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION VOL. 100, NO. 6, JUNE 2008
Conclusion