Rideshare Cuts Colon Cancer Deaths, Saves Costs After Abnormal FIT, Study Finds

Providing rideshare transportation for patients with abnormal fecal immunochemical test (FIT) results could be a cost-saving strategy to improve colorectal cancer (CRC) outcomes, according to a new decision-analytic model.¹ The study found that offering $100 rides increased colonoscopy completion rates from 35% to 70%, reduced cancer cases and deaths, saved more than $330,000 per 1000 people screened, and gained nearly 25 life-years per 1000 participants.

This analysis is published in JAMA Network Open.

A study finds that $100 rideshare rides for follow-up colonoscopy doubled completion rates, reduced colorectal cancer (CRC) deaths, and lowered health care costs. | Image credit: terovesalainen - stock.adobe.com

“Using a microsimulation model, we demonstrated that increasing colonoscopy completion in a population with abnormal FIT results via a rideshare intervention was associated with reduced CRC incidence and mortality and would be cost-saving at a mean cost of $40 or $100 per ride,” wrote the researchers of the study. “Our results suggest that depending on the age at which screening begins and the magnitude of follow-up colonoscopy completion, the rideshare intervention could cost up to a maximum of $498 per ride and remain cost-saving.”

Early FIT screening is increasingly important as CRC rates continue to rise among younger populations.² Starting screening between ages 40 and 49 years, rather than waiting until 50 years, can lead to earlier detection of precancerous lesions and cancers at more treatable stages, ultimately reducing both incidence and mortality.

The study used the CRC-Simulated Population Model for Incidence and Natural History, a microsimulation model designed to project long-term CRC outcomes.¹ Researchers simulated 4 single-age cohorts of 10 million individuals each (ages 45, 55, 65, and 70 years) with sex distributions mirroring the US population. All cohorts were assumed to adhere to annual FIT screening, with baseline analyses estimating that only 35% would complete a follow-up colonoscopy after an abnormal result. The intervention modeled the effect of providing a rideshare service, at a cost of $40 or $100 per ride, to increase colonoscopy completion rates to 70%.

Outcomes measured included CRC cases, CRC deaths, life-years gained, and health care costs over participants’ lifetimes. Data were analyzed from November 2023 to July 2025.

In the simulated cohorts, providing a $100 rideshare intervention starting at age 45 years nearly doubled colonoscopy completion rates, increasing them from 35% to 70%. This improvement was associated with a 26.3% reduction in CRC cases (30.7 vs 41.6 per 1000 people screened) and a 32.5% reduction in CRC deaths (9.8 vs 14.6 per 1000). The intervention also resulted in 24.9 additional life-years gained per 1000 people screened.

From a cost perspective, the rideshare program cost $43,308 per 1000 people screened but generated savings of $330,587 per 1000 due to earlier cancer detection and prevention of precancerous lesions, making the strategy cost-saving at the $100 per ride level.

However, the researchers acknowledged some limitations. As with any model-based analysis, the results depended on the accuracy of baseline assumptions, though these were supported by prior data and multiple sensitivity scenarios. The findings preceded a large, randomized trial, so real-world outcomes may have varied. Additionally, costs were modeled at $40 and $100 per ride, but actual savings could differ if adherence is lower or if additional programmatic or beneficiary costs arise.

Despite these limitations, the researchers believe the analysis offers conservative but useful insights to inform future trials on the association between rideshares and CRC outcomes.

“In a simulation model study, we found that rideshare may be an effective and cost-effective intervention to improve follow-up colonoscopy after abnormal noninvasive CRC screening tests,” wrote the researchers. “Clinical trials are needed to validate the association between a rideshare intervention and follow-up colonoscopy completion. The results of this study will be used to identify target populations and to define study outcome goals in a forthcoming randomized clinical trial that includes a rideshare intervention.”

References

1. Issaka RB, Matrajt L, de Lima PN, et al. Modeled cost-effectiveness of a rideshare program to facilitate colonoscopy completion. JAMA Netw Open. 2025;8(9):e2530515. doi:10.1001/jamanetworkopen.2025.30515

2. Steinzor P. Starting colorectal cancer screening at age 40 cuts death risk by 39%, study finds. AJMC®. June 12, 2025. Accessed September 4, 2025. https://www.ajmc.com/view/starting-colorectal-cancer-screening-at-age-40-cuts-death-risk-by-39-study-finds