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State of the science cancer patient navigation
  1. Kris Blackley
  1. Department of Patient Navigation, Levine Cancer Institute, Charlotte, North Carolina, USA
  1. Correspondence to Kris Blackley, Levine Cancer Institute, Charlotte, NC 28204, USA; kris.blackley{at}atriumhealth.org

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Introduction

Patient navigators have been around since the late 1970s, but in many clinics, the role is often misunderstood. The reasons vary but arise from a lack of standardisation across the country. Navigators are tasked with a wide variety of duties, based on what is lacking in the clinics where they work, not necessarily what their optimal role dictates. Often, there is no navigation ‘leadership’ and the responsibilities are determined ad hoc by physicians or clinic managers and not aligned with the true mission of patient navigation. Patient navigation was started by Freeman and Rodriguez, a breast surgeon in Harlem, New York, USA. He noted a significant difference in the 5-year survival of his patients, compared with the national average. Navigation was created to overcome the disparities prevalent in his community and 5 years later, survival rates had increased from 39% to 70%.1

What is the role of patient navigation?

The primary role is to reduce disparities of care that patients with cancer face, by identifying barriers and providing resources. Lack of insurance, financial concerns, cultural issues, poor health literacy and fear are barriers that might prevent someone receiving cancer care. Navigators triage the needs of their patients. They may not always be able to fix issues or concerns that arise, but they can make referrals to people and services who can. These resources may exist in the facility, the community or be national.

A second role is to provide education. Patients are often overwhelmed in the early stages of their diagnosis. It is known patients forget 40%–80% of what physicians discuss, either because too much medical terminology is used, and they …

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Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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