Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the second leading cause of cancer death in the United States. While morbidity and mortality from CRC can be reduced through early detection and treatment, rates of CRC screening are lower than for other preventable cancers. CRC screening rates are especially low among ethnic minorities, non-English speakers, and low-income individuals.
Strategies such as mailed reminders with educational information have been shown to increase cancer screening rates in low-income populations and those with limited English proficiency. More recently, evaluations have been conducted of "navigator programs", which are specifically designed to overcome patients' perceived barriers to screening. These programs use flexible problem-solving rather than providing a predetermined set of services. They often employ individuals who are bilingual and familiar with the social and cultural nuances of the patients they serve. Navigators help guide patients through the complexities of the health care system, coordinating appointments with work schedules and stressing the importance of consistent treatment and follow-up.
While two randomized controlled trials have been conducted to evaluate navigator programs, to date, there have been no evaluations of large-scale studies designed to increase overall rates of CRC screening among low-income communities using a multilingual navigator program. There is a need for a navigator program designed to increase CRC screening rates for patients regardless of their race, ethnicity, language, or insurance status.