Qualitative framework maps patient navigation across cancer care in LMICs

A theory-informed qualitative framework developed from patient-navigation literature provides a common structure for aligning navigation activities with early cancer care across low- and middle-income countries. The framework maps activities to time intervals spanning diagnosis, pre-treatment, treatment, post-treatment and survivorship. In the evidence reviewed by the researchers, navigation activities were most densely concentrated in diagnostic and pre-treatment intervals, while their extension into post-treatment and survivorship varied across cases.

The study is conceptual and implementation-focused; it does not measure whether navigation improves survival, mortality or other clinical outcomes. Delays in cancer care remain a persistent challenge in low- and middle-income countries, according to the study’s background. The authors also note that cancer mortality-to-incidence ratios remain disproportionately high in these settings, linking the challenge to broader goals of health equity and progress toward universal health coverage.

Patient-navigation programmes have emerged as one strategy for improving coordination and reducing delays, but differences in their design and implementation have complicated evaluation of their relationship to early cancer care objectives. To develop the framework, the researchers used a deductive qualitative approach. They operationalized an emerging structure using sensitizing constructs from the Model of Pathways to Cancer treatment, or MPT, including events, processes and time intervals.

The MPT provided the organizing concepts for examining when patient-navigation activities occur and how they function during the cancer-care pathway. Framework refinement was then guided by observed evidence across cases. This combination of theory-informed mapping and case-based refinement was intended to make the proposed structure usable for implementation, comparison and future evaluation rather than merely descriptive.

The resulting framework extends the MPT with two additional intervals: post-treatment and survivorship. It also identifies patient-navigation processes relevant across these stages, expanding attention beyond the initial diagnostic and treatment phases. The mapping showed a consistent relationship between navigation activities and defined time intervals, with the greatest concentration appearing during diagnosis and before treatment.

The pattern documents where navigation activity is currently positioned, while the variable reach into later stages shows that the duration and continuity of support differ across the cases examined. By classifying patient-navigation programmes according to both timing and function, the framework offers a way to describe what navigation does at different points in the cancer continuum. This structure can support more consistent evaluation, replication and scale-up by making it possible to compare activities that otherwise fall under the broad label of patient navigation.

The study also gives post-treatment and survivorship a more explicit place in the framework, areas that had not been included as separate intervals in the MPT structure used for the analysis. The authors describe the framework as a contribution to strengthening cancer-control systems and advancing equitable progress toward universal health coverage. Because it is based on literature and implementation evidence rather than an outcome trial, its principal contribution is a shared framework for organizing and assessing patient-navigation work; the supplied findings do not establish clinical effectiveness or a causal effect on cancer outcomes.

Subject of Research: Conceptual framework for cancer patient navigation across the care continuum in low- and middle-income countries

Article Title: Aligning patient navigation activities with the early cancer care agenda in LMICs: a framework for implementation across the cancer continuum

Article References: Bautista-González, E., Guzman Montero, P., Mosquera Metcalfe, I., Fernandes Agreli, H. L., Lopes Carvalho, A., Pikhart, H., Peasey, A., & Vindrola-Padros, C. (2026). Aligning patient navigation activities with the early cancer care agenda in LMICs: a framework for implementation across the cancer continuum. BMC Cancer. https://doi.org/10.1186/s12885-026-16608-9

Image Credits: AI Generated

DOI: 10.1186/s12885-026-16608-9

Keywords: patient navigation, cancer care, early diagnosis, care coordination, low- and middle-income countries, implementation frameworks, cancer survivorship, health systems, Aligning, patient, navigation, activities