Cost analysis review of a patient navigator and fecal immunochemical testing on colorectal cancer screening in an underserved population

Background Colorectal cancer screening is a critical preventative service and part of routine patient care, yet a substantial portion of the population fails to undergo recommended screening. Aims To investigate the impact and cost-effectiveness of a patient navigator on colorectal cancer screening via fecal immunochemical testing. Methods Design: retrospective analysis investigating structured outreach via a dedicated patient navigator. Location: Center for Primary Care, Rhode Island Hospital’s primary safety-net clinic for adult patients in Providence, Rhode Island. Timing: the study ran between 01/2017 and 12/2021, with the intervention introduced 01/2021. Results This study included 3542 patients. The intervention improved completion rates from 64.7 to 74.5% at 1 month (HR 1.12, 95%CI [1.003–1.243]), 73.7% to 90.1% at 3 months (1.28[1.156–1.410]), and 87.8 to 98.8% at 1 year (1.36 [1.239–1.498]). Overall, completion rates were improved by 38.5% (1.39[1.260–1.522]). Total cost of colorectal cancer screening per patient was decreased by $874.18 in the post-intervention group ($72.0 ± 383.3 vs. $946.1 ± 1873.5, p