Navigation and clinician payment investments enhance colorectal cancer screening benefits.

Zaire PJ, Fendrick AM, Kurlander JE, Radhakrishnan A. Navigation and clinician payment investments enhance colorectal cancer screening benefits. The American journal of managed care. 2025 Aug 1; 31(8):381-383, DOI: 10.37765/ajmc.2025.89743.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.    Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions

Search for Abstract from PubMed

---

Abstract:

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. Recent policies eliminating patient cost sharing for follow-up colonoscopies address one critical barrier but fail to overcome the systemic obstacles that impede screening completion. Patient navigation programs are a proven strategy to bridge these gaps. By addressing logistical, financial, and educational challenges, navigation services significantly improve follow-up colonoscopy rates. However, inadequate reimbursement has hindered their widespread implementation. Current funding models, including CMS'' Principal Illness Navigation services, fall short of supporting preventive care such as CRC screening. To fully realize the potential of CRC screening, investments in patient navigation, enhanced clinician reimbursement for follow-up colonoscopies, and systemic reforms are essential. Modeling studies reveal a "win-win-win" scenario: Clinicians receive appropriate compensation for their critical role in follow-up care, payers achieve cost savings through efficient screening processes, and investments in navigation services help close disparities in CRC screening. Expanding navigation programs and incentivizing follow-up colonoscopies would increase screening rates, reduce disparities, and achieve population health gains. These investments represent a rare opportunity to align stakeholder interests, prevent CRC deaths, and advance health equity.