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Updated: Sep 8, 2025

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Modeled Cost-Effectiveness of a Rideshare Program to Facilitate Colonoscopy Completion.

Rachel B Issaka1,2,3, Laura Matrajt4,5, Pedro Nascimento de Lima6

  • 1Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington.

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|September 4, 2025
PubMed
Summary
This summary is machine-generated.

Providing rideshare services for abnormal fecal immunochemical tests (FIT) significantly improves colonoscopy completion, leading to fewer colorectal cancer (CRC) cases and deaths. This intervention is cost-effective, saving healthcare resources through early detection and prevention.

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Area of Science:

  • Oncology
  • Public Health
  • Health Economics

Background:

  • Colorectal cancer (CRC) screening via fecal immunochemical tests (FIT) often faces low follow-up colonoscopy rates.
  • Transportation barriers are a significant factor contributing to missed follow-up appointments after abnormal FIT results.

Purpose of the Study:

  • To evaluate the effectiveness and cost-efficiency of a rideshare intervention aimed at increasing colonoscopy completion rates.
  • To model the impact of rideshare support on CRC incidence, mortality, and healthcare costs.

Main Methods:

  • A microsimulation model (CRC-Simulated Population Model for Incidence and Natural History) was employed to simulate population-based CRC screening.
  • Baseline colonoscopy completion after abnormal FIT was set at 35%, with interventions involving rideshare costs of $40 or $100.
  • Simulations analyzed lifetime outcomes including CRC cases, deaths, life-years gained (LYG), and associated costs.

Main Results:

  • A $100 rideshare intervention increased colonoscopy completion from 35% to 70% in simulated cohorts.
  • This intervention was associated with a 26.3% reduction in CRC cases and a 32.5% reduction in CRC deaths per 1000 people.
  • The intervention yielded 24.9 LYG per 1000 people and was cost-saving, with a net saving of $330,587 per 1000 people screened.

Conclusions:

  • Rideshare interventions are a cost-effective strategy to overcome transportation barriers and improve colonoscopy completion after abnormal FIT results.
  • The combined benefits of cancer prevention and early detection make rideshare support a valuable tool in population-based CRC screening programs.
  • Investing up to $100 per ride in transportation assistance can lead to significant reductions in CRC burden and healthcare expenditures.