The Global Cancer Institute recently announced the results of its Patient Navigation Program in Mexico City. The average time to referral before the program’s inception was 5 months, but the implementation of patient navigators reduced that average to 7 days. These findings were published by Yanin Chávarri-Guerra, MD, and colleagues in The Oncologist.1
Yanin Chávarri-Guerra, MD
“Interventions aimed at improving access to timely cancer care for patients in low- and middle-income countries are urgently needed,” said Dr. Chávarri-Guerra, a medical oncologist at the Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. “Patient Navigation is a low-cost, low-technology solution that has a big impact. We believe this is a program that should be emulated in hospitals in [low- and middle-income countries] around the world.”
Cancer mortality rates in Mexico are in part driven by late diagnosis and limited access to care. Mexico’s health-care system is highly fragmented, which represents a challenge for referrals between primary care hospitals and cancer centers. Previous studies conducted within the Mexican health-care system have shown that health system delays for patients with breast cancer have a median length of 5 months, and these delays are closely correlated with a higher frequency of advanced stages at diagnosis.
The program ran from January 2016 through March 2017, and tracked 70 patients at Ajusco Medio General Hospital. The most common barriers in this study were reported as financial burdens and fear; other examples are lack of transportation and family support. Median time to referral was 7 days, and time to specialist appointment was 27 days. Ninety-one percent of patients successfully obtained appointments at cancer centers in less than 3 months.
“By 2025, 60% of new cancer cases and 68% of all cancer deaths will occur in the developing world, and health systems in these countries are struggling to respond to the rising cancer burden,” said Dr. Chávarri-Guerra. “We look forward to working closely with the Global Cancer Institute to replicate this program and its stellar results at other hospitals in our region.” ■
DISCLOSURE: For full disclosures of the study authors, visit theoncologist.alphamedpress.org.
1. Chávarri-Guerra Y, Soto-Perez-de-Celis E, Ramos-López W, et al: Patient navigation to enhance access to care for underserved patients with a suspicion or diagnosis of cancer. The Oncologist. November 29, 2018 (early release online).