Monitoring and developing volunteer patient navigation intervention to improve mammography compliance in a safety net hospital.

62 Background: Mammography screening is crucial for cancer detection. Screening rates have been declining in patients of low socioeconomic status and minorities, supporting the need for intervention at our safety-net hospital. Methods: Patients with a primary care provider order for screening mammograms over a one month period were monitored for 90 day compliance. This analysis determined compliance rate and optimal intervention period. A prospective randomized trial was done to improve compliance using a volunteer patient navigator. All patients received educational material and were randomly assigned to the control or intervention group. The latter were further educated on breast cancer and mammograms and, if amenable, were escorted to a walk-in mammogram. The study period was 3 weeks with 49 participants-24 patients in the control and 25 patients in the intervention group. The principal outcome was the 14 day mammography compliance rate. Secondary analysis examined efficacy of the study with respect to patient demographics, prior mammography compliance, family history of cancer, beliefs on mammography and past medical history and analyzed using GraphPad Prism 7. Results: Analysis revealed a noncompliance rate of 52% with majority compliance occurring within two weeks of order placement. The patient navigation intervention significantly improved compliance by 34% (42% in the control group, 76% in the intervention group, p < 0.05 Fisher exact test). Intervention significantly improved compliance in patients with low susceptibility to cancer belief, who understood benefits of mammography and early diagnosis (p < 0.05 Fisher exact test), had a prior mammogram (p < 0.05 Fisher exact test), a family history of cancer (p < 0.01 Fisher exact test), hyperlipidemia (p < 0.05 Fisher exact test), and those employed (p < 0.05 Fisher exact test). Conclusions: A system to monitor compliance and intervene using patient navigation significantly improved mammography compliance of patients in a safety net urban hospital. The relatively straightforward design of the volunteer based intervention makes it affordable, easily replicable and perhaps beneficial at other institutions.

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Monitoring and Developing a Volunteer Patient Navigation Intervention to Improve Mammography Compliance in a Safety Net Hospital

Journal of Oncology Practice ◽

10.1200/jop.18.00424 ◽

2019 ◽

Vol 15 (4) ◽

pp. e389-e398

Author(s):

Ilana G. Margulies ◽

Judith Zwillenberg ◽

Anisha Chadda ◽

Hannah Gissel ◽

Michael Lettera ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Family History ◽

Patient Navigation ◽

Controlled Trial ◽

Safety Net ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial ◽

Safety Net Hospital ◽

History Of ◽

History Of Cancer

PURPOSE: Although mammography screening is crucial for cancer detection, screening rates have been declining, particularly in patients of low socioeconomic status and minorities. We sought to evaluate and improve the compliance rates at our safety net hospital through a prospective randomized controlled trial of a volunteer-run patient navigation intervention. METHODS: Baseline 90-day institutional mammography compliance rates were evaluated for patients who received a physician order for screening mammograms over a 1-month period. This analysis aided in the creation of a prospective randomized controlled trial of a volunteer-run patient navigation intervention to improve compliance, with 49 total participants. The primary outcome was 14-day mammography compliance rates. Secondary analysis examined the efficacy of the intervention with respect to patient demographics, prior mammography compliance, family history of cancer, beliefs on mammography, and past medical history. RESULTS: Analysis of baseline institutional compliance revealed a 47.87% compliance rate, with the majority of compliance occurring within 14 days of order placement. The patient navigation intervention significantly improved compliance by 34% (42% in the control group, 76% in the intervention group). Additional findings included significantly improved compliance in patients who believed they had a low susceptibility to cancer, those who understood the benefits of mammography and early diagnosis, those who had a prior mammogram, those who were employed, and those with a family history of cancer. CONCLUSION: A system to monitor compliance and intervene using patient navigation significantly improved mammography compliance of patients in a safety net hospital. The relatively straightforward design of this volunteer-based intervention makes it affordable, easily replicable, and perhaps beneficial at other institutions.

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Racial/Ethnic Differences in the Association Between Family History of Cancer and Smoking Status Among US Adults

Annals of Epidemiology ◽

10.1016/j.annepidem.2020.08.025 ◽

2020 ◽

Vol 52 ◽

pp. 103-104

Author(s):

I. Jackson ◽

K. Okhawere ◽

G. Oboli ◽

A. Opiegbe ◽

O. Eromosele

Keyword(s):

Family History ◽

Ethnic Differences ◽

Smoking Status ◽

Family History Of Cancer ◽

History Of ◽

Racial Ethnic ◽

History Of Cancer

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Family history of cancer in first degree relatives and risk of cancer of unknown primary

European Journal of Cancer Care ◽

10.1111/ecc.13485 ◽

2021 ◽

Author(s):

Alexander L. R. Grewcock ◽

Karlijn E. P. E. Hermans ◽

Matty P. Weijenberg ◽

Piet A. Brandt ◽

Caroline Loef ◽

...

Keyword(s):

Family History ◽

Cancer Of Unknown Primary ◽

Unknown Primary ◽

Family History Of Cancer ◽

First Degree Relatives ◽

History Of ◽

Risk Of Cancer ◽

History Of Cancer

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Clinical, Pathological and Molecular Characteristics of Chilean Patients with Early-, Intermediate- and Late-Onset Colorectal Cancer

Cells ◽

10.3390/cells10030631 ◽

2021 ◽

Vol 10 (3) ◽

pp. 631

Author(s):

Karin Alvarez ◽

Alessandra Cassana ◽

Marjorie De La Fuente ◽

Tamara Canales ◽

Mario Abedrapo ◽

...

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Age Of Onset ◽

Late Onset ◽

Molecular Characteristics ◽

Family History Of Cancer ◽

Molecular Features ◽

Age Of Diagnosis ◽

History Of ◽

History Of Cancer

Colorectal cancer (CRC) is the second most frequent neoplasm in Chile and its mortality rate is rising in all ages. However, studies characterizing CRC according to the age of onset are still lacking. This study aimed to identify clinical, pathological, and molecular features of CRC in Chilean patients according to the age of diagnosis: early- (≤50 years; EOCRC), intermediate- (51–69 years; IOCRC), and late-onset (≥70 years; LOCRC). The study included 426 CRC patients from Clinica Las Condes, between 2007 and 2019. A chi-square test was applied to explore associations between age of onset and clinicopathological characteristics. Body Mass Index (BMI) differences according to age of diagnosis was evaluated through t-test. Overall (OS) and cancer-specific survival (CSS) were estimated by the Kaplan–Meier method. We found significant differences between the age of onset, and gender, BMI, family history of cancer, TNM Classification of Malignant Tumors stage, OS, and CSS. EOCRC category was characterized by a family history of cancer, left-sided tumors with a more advanced stage of the disease but better survival at 10 years, and lower microsatellite instability (MSI), with predominant germline mutations. IOCRC has shown clinical similarities with the EOCRC and molecular similarities to the LOCRC, which agrees with other reports.

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THE FAMILY HISTORY OF CANCER PATIENTS.

The Lancet ◽

10.1016/s0140-6736(02)03155-0 ◽

1886 ◽

Vol 127 (3256) ◽

pp. 146-148

Author(s):

W.Roger Williams

Keyword(s):

Family History ◽

Cancer Patients ◽

Family History Of Cancer ◽

The Family ◽

History Of ◽

History Of Cancer

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Abstract 090: Armenian Ethnicity: An Independent Risk Factor for Positive Exercise Treadmill Tests

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.090 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Ara H Rostomian ◽

Daniel Sanchez ◽

Jonathan Soverow

Keyword(s):

Risk Factors ◽

Los Angeles ◽

Multivariate Logistic Regression Analysis ◽

Safety Net ◽

The United States ◽

World Health ◽

Limited Information ◽

Safety Net Hospital ◽

Exercise Treadmill ◽

History Of

Background: Several studies have examined the risk of cardiovascular disease (CVD) among larger racial and ethnic groups such as Hispanics and African-Americans in the United States, but limited information is available on smaller subgroups such as Armenians. According to the World Health Organization, Armenia ranks eighth in CVD rates among all countries however it is unclear if Armenian immigrants living in the US have the same high rates of disease. This study examined whether being of Armenian descent increased the risk of having a positive exercise treadmill test (ETT) among patients treated at a safety net hospital in Los Angeles County. Methods: Data on patients who received an ETT from 2008-2011 were used to conduct a retrospective analysis of the relationship between Armenian ethnicity and ETT result as a surrogate measure for CVD. A multivariate logistic regression analysis was used to estimate the odds ratios (OR) for having a positive ETT among Armenians relative to non-Armenians, adjusting for the following pre-specified covariates: gender, age, diabetes, hypertension, hyperlipidemia, smoking, family history of coronary artery disease (CAD), and patient history of CAD. Results: A total of 5,297 patients, ages 18 to 89, were included. Of these, 13% were Armenian and 46% were male, with an average age of 53 years. Armenians had higher odds of having a positive ETT than non-Armenians (Crude OR=1.30, p=0.037, CI:1.02,1.66). After adjusting for CV risk factors, Armenians were still significantly more likely to have a positive ETT than non-Armenians (OR=1.33, p=0.029, CI:1.03,1.71). CAD (OR 2.02, p<0.001, CI:1.38,2.96), and hyperlipidemia (OR=1.31, p=0.008, CI:1.07,1.60) were also significantly associated with a positive ETT. Conclusion: Armenians have a higher likelihood of having a positive ETT than non-Armenians. This relationship appears to be independent of traditional CV risk factors and suggests a role for cultural and/or genetic influences.

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