Barriers to Oncology-Related Information and Referrals Reported by Oncology Nurse Navigators

Patient navigators provide individualized assistance to patients with cancer in navigating the complexity of the oncology healthcare system.1 By eliminating barriers to quality cancer care, patient outcomes can be improved.1 In oncology, the use of patient navigators has been found to improve cancer screening rates, follow-up care adherence after abnormal test or lab results, and timeliness of diagnostic resolution.1 Oncology nurse navigators likewise help facilitate breast cancer care by providing patients with resources, information, and referral services.1 Two groups of patients with breast cancer who have distinct healthcare needs are those with metastatic breast cancer and young women diagnosed at age 45 or younger. To better understand oncology nurse navigators experiences when caring for these 2 patient groups an online needs assessment survey was sent to 52 oncology nurse navigators who care for these patients. The survey probed the navigators’ familiarity with topics related to patients with breast cancer, referral patterns, along with educational needs perception. Oncology nurse navigators differed on their familiarity with relevant topics for patients with metastatic breast cancer and young women with breast cancer. Navigators with <5 years of work experience reported different navigation experiences than those with >5 years of work experience.

Referrals for both patient groups were given by most oncology nurse navigators for mental health, genetic testing services, and financial services. The survey revealed that 45% of the early-career oncology nurse navigators were familiar with clinical trial participation while 79% of later-career oncology nurse navigators were familiar with clinical trial participation. Early-career oncology nurse navigators referred 35% of young patients with breast cancer and 36% of patients with metastatic breast cancer to clinical trials. Later-career oncology nurse navigators referred 89% of young patients with breast cancer and 89% of patients with metastatic breast cancer to clinical trials. Oncology nurse navigators in the early stages of their career were less likely to refer patients with metastatic breast cancer for genetic testing and counseling, menopause management, sexual health/intimacy services, or health lifestyles services than younger patients with breast cancer. Later-career oncology nurse navigators had similar rates of referral for both patient groups. Many substantial barriers for services were reported by oncology nurse navigators with the most frequently reported barriers being financial or lack of providers/programs for fertility preservation, patients not understanding the value of clinical trials, and medical jargon/health literacy barriers related to clinical trials. Most oncology nurses expressed an interest in continuing education on sexual health and intimacy and a need for patient resources for sexual health/intimacy issues, complementary/alternative medicine, and mental health issues.


Owens K, Dean M, Bourquardez-Clark, E, et al. Needs of oncology nurse navigators serving young or metastatic breast cancer patients. Poster presented at: San Antonio Breast Cancer Symposium. December 7, 2023; San Antonio, TX. Abstract # PO4-10-11.


  1. Baik SH, Gallo LC, Wells KJ. Patient Navigation in Breast Cancer Treatment and Survivorship: A Systematic Review. J Clin Oncol. 2016;34:3686-3696.

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