Background

CANTO Collaborative is a partnership (The Baylor College of Medicine-MD Anderson-Harris Health Cancer Patient Navigation) to use patient navigation (PN) to address disparities in cancer outcomes and promote health equity. We expanded PN from cancer prevention to new lung cancer patients and are evaluating time from diagnosis to treatment in our safety net population in Harris County, Texas.

Methods

Our partnership obtained funding to implement and evaluate the impact of PN on the timely delivery of lung cancer care. Our implementation established workflow and incorporated a trained patient navigator into our multi-disciplinary team. Our patient population is newly diagnosed lung cancer patients at Harris Health System (HHS). Our PN provides telephone-based individual navigation services designed to address barriers to care. Of reported wait intervals in cancer care, the most commonly used metric is time from diagnosis to treatment. In our study this was defined as date of collection for pathologic diagnosis to the date of first treatment (infusion, radiation therapy or surgery). We compared time from diagnosis to treatment prior to our program with preliminary post-implementation data.

Results

Baseline data from lung cancer patients treated HHS (n=149) in 2020 is compared with PN data from new lung cancer patients (n=101) diagnosed in 2023. Demographic characteristics is presented in table 1 showing a diverse population. On average PN reduced days from diagnosis to treatment from 153 days to 53 days (Table 2). Table 3 stratifies this by stage. Other collected metrics include navigation caseload, no show rate, and barriers to care.

Conclusions

Our data showed an improvement in time from diagnosis to treatment following the implementation of our lung PN program. PN is an important resource to reduce barriers to care so that our advances in cancer treatment are accessible to all populations, including vulnerable.

Table 1.Demographic data
Demographics 2023 Navigated Patients
Age Range 30 – 80+
Race
American Indian/Alaskan Native
Asian
Black/African American
Native Hawaiian or Pacific Islander
Other
White
Two or More Races
Prefer Not to Answer
2
7
33
0
9
29
8
0
Ethnicity
Hispanic or Latino
Not Hispanic or Latino
24
56
Gender Identity
Woman
Man
36
85
Table 2.Days from Diagnosis (pathologic) to Treatment (initiation) in 2022 baseline vs 2023 navigated patients
Data Collection from: JULY 1, 2022 - DECEMBER 31, 2022
Average # of Days
Diagnosis to Treatment 153.0
Data Collection from: JANUARY 1, 2023 - JUNE 30, 2023
Average # of Days
Diagnosis to Treatment 27.4
Data Collection from: JULY 1, 2023 - DECEMBER 31, 2023
Average # of Days
Diagnosis to Treatment 29.1
Table 3.Comparison of 2020 baseline data to 2023 data with PN implementation
Stage Number
Diagnosed
2020
(149)
Days to treatment
- Average
2020
Days to Treatment
- Average
2020
Number
Diagnosed
2023
(104)
Number
Navigated
(75)
Days to Treatment
- Average
2023
Diagnosed outside HHS Diagnosed within
HHS
With PN
I 19 142 (99-175) 98 (0-190) 19 16 59.81 (0-170)
II 5 8 7 41.71 (0-90)
III 24 68 (10-180) 71 (4-256) 12 6 81.16 (29-161)
IV 93 29 (9-96) 36 (4-163) 65 46 48.39 (0-153)