ArticleCancer2025
Effectiveness and cost of implementing a patient navigation program to increase colorectal cancer screening in a large federally qualified health center.
Article in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
introductionThe purpose of this study was to evaluate the effectiveness and cost of a patient navigation (PN) program in a large federally qualified health center (FQHC).
methodsThe PN program implemented at AltaMed was evaluated; it is an FQHC that participated in the Centers for Disease Control and Prevention's Colorectal Cancer Control Program. A tailored data collection tool was developed to collect time and resources spent on program activities, salaries of staff, nonlabor resources, and process and outcome measures for 2021-2023. Sociodemographic characteristics and screening uptake for 2020-2023 was collected. Screening uptake and percentage of stool-based tests returned by year and intervention type and compared process measures was calculated, as was the cost of strategies used to increase uptake of stool-based colorectal cancer screening tests.
resultsThe percentage of fecal immunochemical tests (FIT) returned among those receiving the PN program ranged from 36.6% in 2021 to 51.0% in 2023. The total annual cost for PN, mailings of FITs, and cost of the FIT kits ranged from $328,000 to $388,000 across the 3 years. The FQHC cost per person completing FITs decreased from $32 in 2021 to $25 in 2023. The total cost (FQHC and payer reimbursement) was calculated at $54 in 2021, $44 in 2022, and $47 in 2023 for each person completing FIT. The total cost was $512 in 2022 and $513 in 2023 per person completing Cologuard.
conclusionThe PN program, which used reminder texts and calls, alongside mass mailings of stool kits, increased kit returns over the implementation period.
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