Patient Navigation Increases Breast, Cervical, and Colorectal Cancer Screening Among Immigrants in the U.S.: A Systematic Review.

BACKGROUND

The growing immigrant population in the United States faces disparities in cancer screening rates compared to U.S.-born individuals. Despite initially better health outcomes, foreign-born individuals experience declining health with prolonged residence in the U.S., typically exacerbated by lower utilization of preventive services such as cancer screenings. This systematic review examines the role of patient navigation (PN) programs in addressing disparities in colorectal, breast, and cervical cancer screenings among immigrant populations.

METHODS

A comprehensive search of PubMed, Web of Science, and Scopus was conducted. Eligibility criteria encompassed immigrant populations in the U.S. and their access to cancer screenings facilitated by PN programs. Risk of bias was accessed using tools developed by Cochrane for systematic reviews.

RESULTS

Eighteen articles were included in the review. Data was extracted to highlight language spoken, country of origin, type of cancer screening, and specific details of navigation that were received. PN interventions, often delivered by bilingual community health workers or lay health educators, significantly increased screening rates for colorectal, breast, and cervical cancers compared to control groups in most studies. The most notable improvements were seen in colorectal cancer screening rates, where interventions raised screening completion from 10.8 to 89.7% in some populations. Key components of successful PN programs included education, appointment scheduling, and language support.

DISCUSSION

The findings suggest that PN services are crucial in mitigating barriers such as language, cultural differences, and education which contribute to lower screening rates among immigrants. This review underscores the need for culturally and linguistically tailored PN programs to increase preventative cancer screenings in immigrant populations. Strengths of the review include capturing studies across different regions of the U.S. and numerous ethnicities. Limitations include lack of long-term follow-up. The review was registered to PROSPERO with the identification number CRD42023470973.