Maintaining a Working Knowledge of Evidence-Based Information

One of the goals of the Oncology Navigation Standards of Professional Practice is to enhance the quality of professional navigation services provided to people impacted by cancer.¹ To deliver high-quality, competent, and ethical services to people impacted by cancer, a critical piece of working knowledge of evidence-based information is the promotion and education of screening and early detection guidelines. A navigator may be focused on one disease, but they are seen as a trusted healthcare professional and will be queried for information outside of their specified role.

The new recommendations for breast cancer screening by the US Preventive Services Task Force (USPSTF) for women at average risk of developing breast cancer is an example of critical knowledge. The average risk of a woman in the United States developing breast cancer in her lifetime is 1 in 8 (13%), and this accounts for about 30% of all new female cancers annually.² With those odds, it is likely that all navigators know someone who has the disease or will be asked about the disease as a source of information in their community. In its updated recommendations, the USPSTF recommends that all women undergo routine breast cancer screening every other year beginning at age 40 years until age 74, and the updated recommended primary screening modalities include digital breast tomosynthesis (3D mammography).³

This does not cover women at high risk who have a lifetime risk of breast cancer of 20% or greater or have a known BRCA1 or BRCA2 gene mutation. The USPSTF issued a statement on risk assessment, genetic counseling, and genetic testing for BRCA-related cancer, but management of increased cancer risk is beyond the scope of those recommendations.⁴ The American Cancer Society has screening recommendations for women at high risk.⁵

A navigator may have basic screening knowledge for the most common cancers, and when questioned about something that is beyond their knowledge base, their professional standards of care direct them to collaborate with other healthcare and service providers to enhance communication in the best interest of patients. All oncology navigators continue to seek knowledge that reflects current practice.

References

1. Franklin E, Burke S, Dean M, et al. Oncology Navigation Standards of Professional Practice. Journal of Oncology Navigation & Survivorship. 2022;13(3):74-85.
2. Breastcancer.org. Breast Cancer Facts and Statistics. www.breastcancer.org/facts-statistics
3. US Preventive Services Task Force. Breast Cancer: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening#:~:text=The%20Task%20Force%20now%20recommends%20that%20all%20women%20start%20getting,screened%20when%20they%20turn%2040
4. Owens DK, Davidson KW, Krist AH, et al. Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2019;322:652-665.
5. American Cancer Society. American Cancer Society Recommendations for the Early Detection of Breast Cancer. www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html