Development and Implementation of a Cancer Navigation Program for Patients with Gastric Cancer within a Safety-Net Hospital System

Specialty: Surgical Oncology, Oncology

Keywords: Cancer navigation, gastric cancer, safety net

Background: Cancer navigators, who provide personalized support in navigating the healthcare system, have been shown to improve outcomes in various cancers by addressing social barriers to care, enhancing patient understanding, and promoting timely care. However, limited research exists on the specific impact of cancer navigation programs in the context of gastric cancer, and within safety net hospital systems. This study aims to evaluate the effectiveness of cancer navigation in improving patient satisfaction, psychological well-being, and quality of life for patients with gastric cancer in these vulnerable settings.

Objective: To develop and implement a cancer navigation program for patients newly diagnosed with gastric cancer within a Los Angeles County hospital system. To determine the effectiveness of cancer navigators in improving patient quality of life, patient satisfaction, psychological well-being, and clinical outcomes throughout a patient's treatment course.

Methods: This is a prospective cohort study that is evaluating a cancer navigation program for adults newly diagnosed with gastric cancer in the Los Angeles County safety-net hospital system. Each participant is assigned a cancer navigator who provides individualized support, including help with social barriers, appointment coordination, and care team communication. Navigators are required to completed a relevant training course (GW SOM Cancer Center’s Oncology Patient Navigator: The Fundamentals), are cross-trained across cancer types, and participate in physician-led gastric cancer educational sessions. To evalue quality of life, patient satisfaction, and psychological well-being, participants complete validated questionnaires at three time points: at enrollment (baseline), 3-months post-enrollment, and 6-months post-enrollment. These include:

• Quality of life: Functional Assessment of Cancer Therapy-Gastric (FACT-Ga)
• Psychological well-being: Hospital Anxiety and Depression Scale (HADS)
• Patient satisfaction: Patient Satisfaction Questionnaire (PSQ-III)

Surveys are administered in English or Spanish, in person or via Research Electronic Data Capture (REDCap), based on patient preference. Analysis will include descriptive statistics and repeated-measures ANOVA, with significance set at p < 0.05.

Results: Recruitment for this prospective cohort study is ongoing. As of April 2025, 4 participants have been enrolled out of a planned sample size of 100. Of these, four participants have completed baseline surveys. Preliminary engagement with the navigation program has been promising, with no participants lost to follow-up thus far.

Conclusion: Early implementation of a cancer navigation program within a safety-net hospital setting shows promise in supporting patients with newly diagnosed gastric cancer. While recruitment is ongoing, initial engagement suggests feasibility and patient receptiveness. Continued data collection will clarify the program’s impact on patient satisfaction, psychological well-being, and quality of life, potentially guiding future navigation efforts in underserved populations.