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Patient Navigators Boost Colon Screens in Urban Minorities
Date:4/4/2008

Personal interventions cut no-show rates 30%, study finds

FRIDAY, April 4 (HealthDay News) -- Two new studies make the case that more personal guidance and encouragement will help increase the numbers of low-income and minority patients getting recommended screening for colorectal cancer.

The studies, published in current issue of Clinical Gastroenterology and Hepatology, found problems with large "safety net" health-care systems serving urban populations and hope for patient intervention programs featuring "navigators" that guide patients through preparation for the procedure and encourage their attendance.

Colon cancer, when detected early, is one of the most treatable of all cancers, with a five-year survival rate of 90 percent. However, diagnosis in the most advanced stage of the disease causes that survival rate to drop only 10 percent. The American Gastroenterological Association Institute estimates 148,800 people will be diagnosed with colorectal cancer in 2008, and almost 50,000 will die from the preventable disease.

In the first study, a research team studied six months of endoscopy laboratory scheduling and procedure logs from Denver Health Medical Center. They found 41.7 percent of the 817 people scheduled for outpatient colonoscopies failed to show. Of those who did make their appointments, 30.2 percent did not prepare their bowel properly to take the examination.

According to the Denver study, such safety net systems traditionally have a large proportion of low-income and minority patients, and their colonoscopy no-show rates are "very high." The researchers said the rate of colonoscopy non-attendance at Denver Health is comparable to similar institutions in the United States but much greater than the no-show rate at non-safety-net systems.

"Because the rationale and required steps for completing colonoscopy are complex, individual intervention with patient navigators -- no
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