Using Patient Navigation to Increase Completed Follow-up Testing in Women with Abnormal Screening Results in the Louisiana Breast and Cervical Health Program (LBCHP).

Authors:

Nannozi Ssenkoloto (Presenter)
Louisiana State University School of Public Health

Ting Luo, Louisiana State University School of Public Health
Tyler Bartley, Louisiana State University School of Public Health
Mikal Giancola, Louisiana State University School of Public Health
Donna Williams, Louisiana State University Health Science Center

Public Health Statement: The goal of the Louisiana Breast and Cervical Health program (LBCHP) is to prevent unnecessary disease, disability or premature death due to cancer of the breast and cervix in Louisiana. Early detection of breast and cervical cancer is an effective way to reduce the morbidity and mortality burden from cancer. To accomplish this, LBCHP provides quality, no-cost, breast and cervical cancer screening services to uninsured and underinsured, low and moderate-income Louisiana women aged 21 to 64. This study describes the effect of one component of this program-patient navigation- to ensure underserved women with abnormal results complete breast and cervical cancer follow-up testing.

Purpose: The LBCHP provides quality, no-cost, breast and cervical cancer screenings to uninsured and underinsured women. One component of the program is patient navigation, which is a patient-centered intervention that ensures patients receive timely cancer screenings, treatment, and follow-up care by reducing barriers. Certain racial and ethnic minority groups have disproportionately lower screening rates, which creates a gap in health outcomes among women in the United States. The goal of this study was to determine whether providing patient navigation services resulted in women with abnormal screening results completing follow-up.

Methods/Approach: A retrospective cross-sectional study design was used, resulting in 49,741 women aged 21 to 64 who received breast or cervical cancer screenings between July 1, 2011 and June 30, 2016 were included in the study. Eligible women, received one or more screenings, including mammography, Pap tests, and follow-up diagnostic testing. Health providers reported each encounter into a database. Descriptive statistics was used to analyze the de-identified data.

Results: LBCHP provided 52,672 mammograms and 16,073 Pap tests. Breast cancer screenings found 13,246 patients with abnormal diagnoses, 98.8% (n=13,088) of those completed follow-up. Nighty-two percent of patients with abnormal breast cancer results received a final diagnosis within 60 days. Cervical cancer screenings found 109 patients with abnormal Pap tests and 95.4% (n= 104) completed follow-up. Eighty-eight percent (n=88) of patients with abnormal Pap tests received a final diagnosis within 90 days.

Conclusions/Implications: The LBCHP successfully met the recommended CDC performance standard for complete and timely follow-up by using patient navigation to ensure complete follow-up.