“My brother would not have usually interacted with people in a setting like a hospital because he’s had a lot of problems… The way they treat black men in medical things.”
“I didn’t feel insecure about every little thing because she told me to call her if there was anything I didn’t understand… I felt supported.”
These words capture the experiences of patients who participated in a pilot program at Fred Hutchinson Cancer Center that aimed to address the disparities in cancer care often experienced by systemically marginalized patients.
The Fred Hutch/University of Washington/Seattle Children's Cancer Consortium serves a diverse patient base across Washington state, with an overarching mission to foster healthier lives for every person in every community. Advances in cancer prevention and treatment have contributed to a substantial decline in overall cancer rates and mortality over the past few decades, yet these benefits are not shared equally. Patients from minoritized racial and ethnic backgrounds continue to face disproportionately worse cancer outcomes.
The 2023 Community Health Needs Assessment reported that in Washington state, African-American, American Indian/Alaska Native, and Hispanic/Latino patients all have higher mortality rates for multiple cancer types compared to other ethnic groups. Race and ethnicity shape patient outcomes in ways that are independent of biological factors. Systemic discrimination and a lack of access to resources perpetuate mistrust in the healthcare system and impact care quality.
In a collaborative effort fostered by the Cancer Consortium, researchers from Fred Hutch, the University of Washington, and Seattle Children’s Hospital, explored a new patient navigation model to mitigate these disparities.
The healthcare system is complex and difficult to navigate for anyone, particularly while facing a cancer diagnosis. Beyond the medical challenges, there are often many practical, financial, and emotional obstacles to receiving appropriate care. Navigators help ensure patients get the right support by coordinating treatment, addressing barriers to access, and connecting them to resources. In addition to providing logistical support, navigators educate, empower, and advocate for people with cancer.
A navigation program launched in 2007 at Fred Hutch helped many participants address acute concerns by connecting them with tangible resources through a referral. But the very patients most at risk of poor cancer outcomes were not being reached in this model. To address this gap, a new racially, ethnically, and linguistically concordant (RELC) model of navigation was developed, with findings now published in the Journal of Health Equity. The program paired Fred Hutch patients who identified as American Indian/Alaska Native, African-American, Asian and Pacific Islander, or Spanish-speaking, with navigators who shared the same background. Beyond matching participants and navigators on the basis of race, ethnicity, and language, the RELC model takes the traditional navigation approach a step further in two key ways. Services are offered in a proactive manner, with navigators pre-emptively contacting patients from communities with known disparities in cancer outcomes, and the program is longitudinal, allowing navigators to build trust and form lasting connections.
Research shows that when patients and their providers have a shared background, the impacts of racism within the healthcare system are reduced. As author Ashlyn Tom puts it,
Trust in care begins when patients see themselves reflected in the people who serve them. When patients can engage with providers who reflect their identities and experiences, it strengthens every interaction. That’s why representation matters.
Surveys and one-on-one interviews were used to assess satisfaction with care and provide deeper insights into patient experiences. Although the small sample size limits the ability to make definitive conclusions, this work offers immensely valuable insights that demonstrate how RELC navigation can improve patient experiences and advance equity in cancer care.
Patient responses were resoundingly positive. Many reported that having a navigator who shared their background made them feel more understood, increased comfort, and built trust. The interviews also highlighted that RELC navigators played a key role in helping patients overcome racism and language barriers that often hinder access to care. Author Citlali Gomez-Acosta shared,
Working as a Spanish medical interpreter showed me how deep communication can shape care for patients. I was able to witness first-hand how language and cultural barriers can make patients feel unseen. This highlighted that care is not only about medicine, but also connection, respect and understanding.
The impact of patient navigation is deeply personal. Health outcomes are shaped by access, communication, and trust. The RELC model acknowledges these realities and steps in where the system falls short for minoritized populations. This new approach to patient navigation offers a promising framework to ensure more people get the care they need, when they need it, regardless of background or circumstances.
The spotlighted research was funded by the National Cancer Institute.
Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium Members Drs. Jason A. Mendoza, Wendy E. Barrington, Yaw A. Nyame, and K. Casey Lion contributed to this research.
Tom A, Gomez-Acosta C, Henderson V, McDougall J, Mendoza JA, Carosso E, Cohn EB, Barrington WE, Bigelow-Chavez L, Nyame YA, & Lion KC. 2025. Advancing equity in cancer care: a pilot explanatory mixed methods study of a racially, ethnically, and linguistically concordant model of patient navigation. Journal of Health Equity. DOI: 10.1080/29944694.2025.2562057