Assessing the effect of patient navigator assistance for psychosocial support services on health-related quality of life in a randomized clinical trial in Latino breast, prostate, and colorectal cancer survivors

Cancer. 2020 Mar 1;126(5):1112-1123. doi: 10.1002/cncr.32626. Epub 2019 Nov 19.

Abstract

Background: After a diagnosis of prostate, breast, or colorectal cancer, Latinos experience higher mortality rates and lower health-related quality of life (HRQOL) in comparison with other ethnic/racial groups. Patient navigation (PN) and lay community health workers or promotores are effective in increasing cancer screening and early-stage diagnosis among Latinos. However, little is known about the effect of PN on HRQOL among Latino cancer survivors.

Methods: Latinos previously diagnosed with breast, prostate, or colorectal cancer (n = 288) were randomized to 1 of 2 conditions: 1) the Patient Navigator LIVESTRONG Cancer Navigation Services (PN-LCNS) survivor care program or 2) PN only. HRQOL was measured with the Functional Assessment of Cancer Therapy-General, and cancer-specific HRQOL was measured with the Functional Assessment of Cancer Therapy-Breast, the Functional Assessment of Cancer Therapy-Prostate, and the Functional Assessment of Cancer Therapy-Colorectal for breast, prostate, and colorectal cancer survivors, respectively, at the baseline and at 3 follow-up time points. Generalized estimating equation analyses were conducted to estimate the effect of condition on HRQOL with adjustments for covariates and baseline HRQOL.

Results: PN-LCNS demonstrated a significant improvement in HRQOL in comparison with PN only for colorectal cancer survivors but not for breast and prostate cancer survivors.

Conclusions: Enhanced PN improves HRQOL among Latino colorectal cancer survivors. Future research should identify the best strategies for engaging Latino survivors in PN programs. PN programs should also be adapted to address HRQOL concerns among Latina breast cancer survivors.

Keywords: promotores; Hispanic; Latino; breast cancer; colorectal cancer; health-related quality of life; patient navigation; prostate cancer; survivorship.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Breast Neoplasms / psychology
  • Breast Neoplasms / rehabilitation*
  • Cancer Survivors / psychology*
  • Colorectal Neoplasms / psychology
  • Colorectal Neoplasms / rehabilitation*
  • Ethnicity
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Navigation / methods*
  • Prognosis
  • Prostatic Neoplasms / psychology
  • Prostatic Neoplasms / rehabilitation*
  • Psychosocial Support Systems*
  • Quality of Life*
  • Social Support
  • Survival Rate