Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Racial disparities in CRC
incidence and mortality have been well documented. In addition, lower rates of CRC screening among ethnic minorities have
been reported. Therefore, we tested the effectiveness of a patient navigator (PN) in increasing compliance with CRC screening
in a minority community health setting. Men and women aged 50 or older attending a primary care practice were enrolled if
they had not had a fecal occult blood test within the past year, a sigmoidoscopy or barium enema within the past 3–5 years,
or a colonoscopy within the past 10 years. Participants were randomly assigned either to receive navigator services (PN+)
or not to receive navigator services (PN−). There were no demographic differences between the two groups. Within 6 months
of physician recommendation, 15.8% in the PN+ group had complied with an endoscopic examination, compared with only 5% in
the PN− group (P=.019). The PN+ groups also demonstrated higher rates of fecal occult blood test completion (42.1% vs. 25%,
P=.086). Thus, a PN system successfully increases CRC screening rates among a predominantly minority population of low socioeconomic
status.
Keywords Colorectal cancer screening - Fecal occult blood test - Flexible sigmoidoscopy - Urban health