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In 2019, nearly 14 million colonoscopies were performed in the United States. In these settings, the accepted practice is that a responsible person drives and chaperones patients home after receiving procedural sedation, including colonoscopy. Lack of access to transportation and/or a chaperone is a persistent barrier to care in safety-net health systems and federally qualified health centers as a result of lower incomes, underinsurance, and higher social needs. Given racial, ethnic, and socioeconomic disparities in many digestive diseases that require colonoscopy for diagnosis and management, innovative solutions are needed to overcome logistical barriers to colonoscopy completion, especially in these settings.
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http://dx.doi.org/10.1016/j.cgh.2023.09.030 | DOI Listing |
JAMA Netw Open
September 2025
Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington.
Importance: In colorectal cancer (CRC) screening, too many patients fail to receive follow-up colonoscopy after an abnormal fecal immunochemical test (FIT), and transportation is a frequently reported barrier.
Objective: To determine the outcomes and cost-effectiveness of providing a rideshare intervention to patients with abnormal FIT results.
Design, Setting, And Participants: The CRC-Simulated Population Model for Incidence and Natural History microsimulation model was used to simulate the outcomes and cost-effectiveness of a rideshare intervention to improve colonoscopy completion in a population-based CRC screening program.
Endoscopy
September 2025
Dept. of Gastroenterology and Hepatology and Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands.
Background: Bowel preparation is essential for colonoscopy but may deter patients. Although low-volume laxatives are better tolerated, their impact on patient-reported outcomes remains unclear. We compared low- and intermediate volume bowel preparation and assessed the impact on tolerability, health-related quality of life (HRQoL) and work.
View Article and Find Full Text PDFJ Clin Med
August 2025
Gastroenterology and Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, 47121 Forlì, Italy.
Polyp retrieval following colorectal polypectomy remains a critical step for histopathological analysis and determining appropriate surveillance intervals. Despite reported retrieval rates exceeding 90% in the literature, significant heterogeneity persists in clinical practice, particularly for polyps < 10 mm, due to the lack of standardized retrieval methods. This review synthesizes current evidence on polyp retrieval techniques, the impact of lesion size, and device-specific considerations, including suction-based methods, retrieval nets, and other approaches such as the water-bolus and water-slider techniques.
View Article and Find Full Text PDFAm J Manag Care
August 2025
University of Michigan, 2800 Plymouth Rd, Bldg 14, Ste G100, Ann Arbor, MI 48109. Email:
Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the US, with nearly 40% of eligible individuals not current on lifesaving CRC screening. Although stool-based screening tests offer accessible initial options, the CRC screening process is incomplete without a follow-up colonoscopy after a positive result. Unfortunately, low follow-up rates-particularly among socioeconomically disadvantaged groups-undermine the potential health benefits.
View Article and Find Full Text PDFCancer Causes Control
August 2025
Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, Seattle, USA.
Background: Fecal immunochemical tests (FIT) are recommended for routine colorectal cancer (CRC) screening because they are cost-effective, non-invasive, and convenient. Pharmacy-based CRC screening using FIT kits could be effective to improve screening rates, particularly in medically underserved communities. However, data on follow-up procedures and barriers after positive FIT results in this context remain sparse.
View Article and Find Full Text PDF