Abstract B30: Patient navigation for cervical cancer in Kentucky: Baseline results
Authors: White Carol , Dignan Mark , Slone Stacey , Gomez Maria , Jones Kate 
Published: May 2012

Abstract
Background: Although morbidity and mortality rates are low compared to other types of cancer, cervical cancer remains a high priority for the following reasons: 1) invasive cervical cancer is a disease that could be prevented in nearly all cases, with greater use of the Pap test; 2) the Pap test is a well-established, low cost, widely available screening test that should present minimal barriers to its use; and 3) despite our ability to prevent and treat cervical cancer, the burden of cervical cancer morbidity and mortality continues to be higher among low-income women with limited education, many of whom reside in rural areas. Despite public health recommendations for cervical cancer screening and follow-up of abnormal Pap test results, adherence is still low among rural Appalachian women in Kentucky. In response to this concern, the University of Kentucky Prevention Research Center is implementing a National Cancer Institute-funded project that is integrating patient navigators (PN) in cervical cancer screening programs in several rural health departments.
Goal: To reduce the disproportionate burden of cervical cancer experienced by rural Appalachian women in Kentucky.
Objectives: To: 1) improve our understanding of the barriers to follow-up; 2) recruit, train, and utilize lay health workers as PNs in cervical cancer screening programs; 3) increase the proportion of women who adhere to recommended follow-up; and 4) evaluate the efficacy of the intervention.
Method: Intervention activities are as follows: 1) nurse case managers refer patients with abnormal pap tests to PNs in selected local health departments in Big Sandy, Lake Cumberland, and Kentucky River Area Development Districts; 2) PNs enroll patients in the study; 3) study participants complete a baseline interview; 4) PNs provide navigation services including outreach, education, and support; 5) PNs conduct follow-up interviews; and 6) PNs document follow-up recommendations, barriers, patient needs, and specific actions taken to ensure adherence to follow-up recommendations.
Evaluation: To assess the efficacy of the intervention, outcome data will be collected from health department records in intervention and control counties.
Findings: The total number of referrals to date is 600. Among the referrals: 82 (14%) were ineligible (patient less than 18 years, refused services, dropped by health department for non-compliance, or lost to follow-up); 379 (63%) were offered enrollment; and enrollment is pending for 139 (23%). Among those offered enrollment, 297 (78%) agreed to participate in the study. Additional preliminary findings will be presented including reason for referral, characteristics of women enrolled, patient needs, adherence to follow-up, etc.
Conclusions: The program creates a unique opportunity to support rural cervical cancer screening programs, ensuring women obtain their recommended follow-up care through the support of PNs.
Citation Information: Cancer Prev Res 2010;3(1 Suppl):B30.