Study of Patient Navigation to Promote Colon Cancer Screening

Randomized Controlled Trial of Patient Navigation to Increase Colorectal Cancer Screening Rates Among Community Health Center Patients

This study will investigate whether patient navigation can increase rates of colorectal cancer screening among linguistically and culturally diverse disadvantaged patients served by urban community health centers.

Inclusion Criteria:

• Patients aged 52-75 who had one visit to a primary care physician in a community health center in each of the 2 previous years and who have not received colorectal cancer screening based on HEDIS criteria.

Exclusion Criteria:

• Current cancer diagnosis, undergoing treatment (or treatment completed within the past year)
• Severe cardiac disease (high-risk CAD,9 valvular disease, NYHA Class III or IV CHF, EF < 35%)
• Severe COPD (FEV1< 1liter or on home oxygen)
• CVA with severe functional impairment (aphasia or hemiparesis)
• MS with severe functional impairment
• Renal failure with CrCl< 30 or on dialysis
• Gastrointestinal symptoms (pain, bleeding, etc) within the past 6 months
• Chronic active liver disease or cirrhosis, with albumin < 3 or elevated INR
• Advanced HIV disease (CD4 count <200)
• Severe lupus (with cerebritis or renal failure as defined above)
• Severe complications of diabetes (blindness, amputations other than toes)
• Advanced Dementia
• Psychosis
• Paranoia
• Active substance abuse
• Schizophrenia
• Psychiatric hospitalization within the past year