Background: Lung cancer is the leading cause of cancer deaths worldwide, due to advanced stages of disease at presentation. Healthcare systems are increasingly siloed, resulting in a myriad of care transitions that increase the complexity of care, often resulting in poor patient outcomes. Cancer patient navigation (CPN) emerged in Manitoba, as part of the province’s IN SIXTY initiative, with the general aim of guiding patients through the complexities of the healthcare system to reduce barriers to care, streamline services, and promote efficiencies. Since its inception over a decade ago, there has been no formalized evaluation of IN SIXTY and CPN in Manitoba.
Purpose: The aim of this thesis was to measure the impact of CPN in Manitoba on supporting patients with primary lung cancer in achieving timely referral to CancerCare Manitoba (CCMB) and first treatment. Methods: A retrospective, cohort study of Manitoba Cancer Registry and Aria data was completed to compare patients who received care from a nurse navigator as part of CPN to patients who received standard care, on the number of days from lung cancer diagnosis to CCMB referral, and date of first treatment, using multilinear Cox proportional hazards regression analysis. Findings: Patients who received CPN, actualized by nurse navigators, had a statistically significant reduced number of days from lung cancer diagnosis to referral receipt at CCMB, and to the date of first treatment. The timing of CPN, which was found to occur at different points along the cancer continuum, was also found to affect the degree to which CPN impacted timely lung cancer care. CPN implemented prior to lung cancer diagnosis was found to be the most effective model of care. Conclusion: CPN is an effective, nurse-led, model of care, that shortens the time to CCMB referral and first treatment for lung cancer. Further research is needed regarding its impact in other disease sites, and during the suspicion-interval of newly suspected cancer.