Posts tagged School of Medicine
Extra support for patients, called “patient navigation,” can lead to faster diagnosis for Latinas after an abnormal mammogram result, according to a new study by the Institute for Health Promotion Research (IHPR), part of the School of Medicine at The University of Texas Health Science Center at San Antonio.
The study, published this week by the journal Cancer, also suggests that patient navigation should be carefully targeted to have the greatest impact on eventual health outcomes.
IHPR researchers worked with partners in the federally funded Redes En Acción: The National Latino Cancer Network to examine the experiences of 425 Latinas in six cities nationwide. Each woman had received an abnormal result in initial breast cancer screening and was referred for further evaluation.
About half of the women received help from trained patient navigators, who provided culturally sensitive support and help overcoming barriers related to transportation, child care, insurance coverage, language and more. The rest of the patients did not receive patient navigation.
The study’s patient navigators, all Latinas themselves, were high school graduates between the ages of 25 and 47, and were trained to coordinate care according to the same patient navigation model.
For patients who received navigation services, the time between an abnormality being found and eventual diagnosis – whether positive or negative for cancer – was significantly shortened.
Those who worked with patient navigators were diagnosed in an average of 32.5 days, compared with 44.6 days for those who did not receive patient navigation.
“This study demonstrates that patient navigation can influence the time to cancer diagnosis for Latinas,” said IHPR Director Dr. Amelie G. Ramirez and study author.
More specifically, researchers found the greatest benefit for women whose abnormalities were categorized upon discovery as “probably benign” – or BI-RADS-3 on the American College of Radiology’s Breast Imaging-Reporting and Data System.
The likelihood of cancer in a woman with a BI-RADS-3 screening result is about 2-4%.
Health care providers typically instruct these women to return for another screening within six months; however, delays and anxiety occur, appointments are missed and Latinas may skip subsequent screenings altogether, potentially setting the stage for confirmatory diagnoses at more advanced stages of cancer with lower survival probability.
In this study, on average, women with “probably benign” abnormalities received a diagnosis more than 40 days sooner if they worked with a patient navigator.
“For women with more ambiguous screening results, a faster diagnosis through patient navigation relieves them of the burden of worrying about their health,” Dr. Ramirez said. “We can target Latinas who are falling through cracks and prevent situations where cancer advances to worse stages because Latinas aren’t following up an ambiguous screening result.”
Liver cancer rates among South Texas Latinos are higher than in other U.S. Latinos, as are their rates of obesity and diabetes—and the relationships between these ailments are being mapped by researchers at the Institute for Health Promotion Research (IHPR) at The UT Health Science Center at San Antonio, the team behind SaludToday.
In a study published April 18, 2012, in the journal PLoS ONE, the researchers looked at overall liver cancer rates among U.S. Latinos and compared this to a Texas sample and a South Texas subset from 1995-2006.
They also compared prevalence among Latinos of lifestyle-associated factors that contribute to liver cancer: heavy alcohol use, smoking, obesity and diabetes.
They found that from 1995 to 2006, annual age-adjusted liver cancer incidence increased among all populations – but was highest in South Texas Latinos over the entire period. The increase among South Texas Latinos was also significantly greater than all Texas Latinos, who in turn had significantly higher levels of liver cancer than the U.S. national sample.
While obesity and diabetes increased among all three groups, obesity rates were higher in Texas Latinos and highest in South Texas Latinos. Neither heavy alcohol consumption nor cigarette smoking increased.
“Regarding risk factors, we found remarkably similar and significantly increasing rates of obesity and diabetes in our study groups, with higher obesity prevalence in Texas and particularly South Texas Latinos,” said Dr. Amelie G. Ramirez, the study’s lead author and director of the Institute for Health Promotion Research at the Health Science Center.
The study warrants further exploration if there is a relationship between diabetes, obesity and liver cancer so that researchers can look at the problem from the standpoint of prevention, said Ramirez, who also is a professor of epidemiology and biostatistics in the Health Science Center’s School of Medicine and associate director of health disparities at the Health Science Center’s Cancer Therapy & Research Center.
“Both obesity and diabetes are preventable and/or treatable,” she said, “so reducing obesity and diabetes may be an important for lowering Latinos’ risk for liver cancer, too.”