Abstract 972: Identifying patient navigation needs and gaps in cancer care in Puerto Rico: insights from the START-PR study

Abstract Background: Patient navigation (PN) services in cancer care have significantly benefited cancer patients by reducing disparities in cancer outcomes, screening, and treatment. Identifying the characteristics of cancer patients who need PN services and the services they need may assist in the design of targeted future PN programs. Therefore, our study aims to identify the PN services that are most needed in this population and determine the association between the need for PN services among cancer patients in Puerto Rico and sociodemographic and health-related factors. Methods: Our ongoing pilot cross-sectional study, START-PR, has recruited cancer patients aged 21+ years who received active treatment in the last year and resided in Puerto Rico, through an online survey. Data on PN services, sociodemographic, and clinical characteristics were assessed in this study. Multivariate logistic regression models, including covariates with p-values < 0.25 in univariate models, were performed to determine associations between the selected characteristics and the need for PN services. McNemar’s test was used to determine differences in the proportions between the need and the receipt of PN services. Results: To date, 547 individuals have accessed the survey and met the eligibility criteria, with 538 (98.4%) completing the survey. Most of our sample were women (69.2%), aged between 40-64 years (56.1%), had a higher educational attainment than high school (72.6%), and had cancer in localized stages (64.4%). About 29% of the patients self-reported needing PN services. Among these patients (n=156), the most commonly needed services were: (1) coordination of tests, procedures, and treatments (36.5%), (2) education (34.6%), and (3) assistance in scheduling appointments or finding a new doctor (29.5%). Participants aged 40 to 64 (34.8%), with education beyond high school (31.4%), with comorbidities (32.1%), without a partner (32.5%), with public health insurance (34.3%), and diagnosed with cancer for more than a year (32.8%) had higher PN service needs than their counterparts (p<0.25). After controlling for potential confounders, patients with comorbidities had 2.2 times the odds (95% CI: 1.28, 3.79) of needing PN services compared to those without comorbidities. About 10.8% did not need the PN services but ended up receiving them, while 18.4% needed the PN services but did not receive them (p=0.001). Conclusion: The results of this study provide valuable information to guide the design of targeted future PN programs in Puerto Rico. Further studies should include in-depth qualitative methods to better understand the reasons behind these needs and identify the specific barriers patients face to receive cancer care. Fundings: Partially supported by the Office of Cancer Research Training and Education Coordination of the UPR Comprehensive Cancer Center and the Hispanic ALLIANCE (NIGMS-U54GM133807). Citation Format: Lorena González-Sepúlveda, Stephanie Cameron-Maldonado, Karina M. Rivera-Mejía, Natalia E. Domínguez-Betancourt, María M. Vázquez-Torres, Alejandra Díaz-Rohena, Liamarys Ortiz-Torres, Noedly Ayala-Sánchez, Yadielis S. Arce, Nancy Cardona-Cordero, Marievelisse Soto-Salgado. Identifying patient navigation needs and gaps in cancer care in Puerto Rico: insights from the START-PR study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 972.