Aims: Ethnic minority (EM) populations living in high income countries (HIC) often have poorer cancer outcomes and face additional challenges when accessing cancer care. Patient navigation (PN) is an approach to overcome barriers to care, improve outcomes and reduce cancer disparities. This systematic review aimed to evaluate the impact of PN on improving EM cancer care in HICs and identify key characteristics and components of effective oncology PN programs that had positive effects in these populations.
Methods: Peer-reviewed literature in the English language (published between January 2004 - January 2024) was searched in the following databases: PubMed, Ovid MEDLINE, APA PsycINFO, Web of Science, CINAHL, Cochrane Library and Scopus. We included primary experimental or quasi-experimental studies comparing PN programs to usual care, delivered to adult EM patients with any type of cancer, from abnormal finding to survivorship and palliative care.
Results: Eighteen studies were included in this review, all conducted in the United States. Constituent minority populations were Hispanic (35.6%), Black American (27.7%), Native American (13.9%) and Asian (1.2%), with breast and cervical as the most common cancer types. Most studies (13) focused on diagnostic evaluation outcomes. Of the 18 included studies, 15 reported improvements in cancer care outcomes. We encountered significant heterogeneity in PN program characteristics and inconsistencies in methodology reporting. Some common core components and culture-centred features of effective PN programs were identified.
Conclusion: There is a moderate amount of evidence indicating PN is effective in improving cancer care for ethnic minorities, particularly during the diagnostic evaluation phase. This review has identified important characteristics of successful programs that can help shape future oncology navigation services for ethnic minority communities. Additionally, a reporting standards guideline for the publication of oncology navigation studies is proposed, to enhance the comparability across cancer PN research.