What if a ride could save a life? New research says it just might

Most people don’t think twice about calling a ride when they need to get somewhere. But for thousands of people every year who need a colonoscopy after an abnormal stool test, getting a ride isn’t simple at all. In fact, it can be the one thing that stands between them and getting lifesaving care.

The issue is bigger than you might think. Colorectal cancer is still one of the leading causes of cancer-related loss of life in the United States, and screening is one of the strongest tools we have to prevent it. Many clinics use the fecal immunochemical test (FIT), which people can do at home. But FIT is only step one. If the result is abnormal, you need a follow-up colonoscopy. Without that second step, the benefits of screening disappear.

But the problem is that people often can’t get to that appointment. Colonoscopies usually involve sedation, which means patients need someone to pick them up afterward. Plenty of people don’t have someone available, or they can’t take a day off work, or they don’t have reliable transportation. One study even found that lack of a ride or chaperone is one of the most common reasons people skip their colonoscopy altogether.

A new study from researchers at Fred Hutch Cancer Center took a close look at this problem and asked a surprisingly practical question: What if health systems simply offered people a rideshare? Would more patients get the colonoscopy they need? And if so, would it actually save money in the long run? To answer this question, the team used a massive microsimulation model to imagine a virtual population of millions of people.

To try to predict the ultimate outcome of providing transportation, Dr. Rachel Issaka and her colleagues simulated four huge groups of people—each one made up of 10 million individuals between ages 45 and 70. They started with a pretty realistic baseline: only about 35% of people with abnormal FIT results complete their colonoscopy within a year. Then they modeled what would happen if a rideshare program increased that number.

The results were striking. If rideshare access boosted completion from 35% to 70%, the number of colorectal cancer cases dropped by about 26% for people starting screening at age 45. For the same group, colorectal cancer–related deaths dropped by about 33%. These numbers are huge when you think about what they actually represent, thousands of people finding and removing precancerous growths early or catching cancer at a more treatable stage.

And here’s the part that might surprise you: even when the rideshare cost was set at $100 per ride, the program still saved money overall. The model showed savings of more than $330,000 per 1,000 people screened. This happened because preventing cancer, or catching it early, costs far less than treating advanced disease. It’s a simple idea with profound financial and human impacts.

You can see this clearly in the charts in the study. For example, the graphs show sharp declines in colorectal cancer cases and deaths as colonoscopy adherence increases. The trend is the same across all age groups, though the biggest benefits show up when screening starts earlier.

The model also explored just how high the ride cost could be before the program stopped saving money. For 45-year-olds, rides could cost up to $498 each and it would still be cost-saving. That number is mind-blowing. It shows just how valuable follow-up colonoscopy really is, and how much is lost when people miss it.

There’s also a human side to this that models can’t fully capture. When people skip follow-up care, it’s not because they don’t care about their health. It’s often because the system wasn’t designed with their real lives in mind. Transportation might sound like a small thing, but for many people, especially those juggling jobs, caregiving, or tight budgets, it’s a real barrier. Instead of waiting for some future innovation, this deeply practical research asks: what can we do right now? What if a simple ride could help someone catch cancer early? What if a reasonably priced program could save health systems money and save people from unnecessary suffering?

Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium Members Drs. Rachel Issaka and Carolyn Rutter contributed to this research.

This research was supported by the NCI of the NIH and the Cancer Intervention and Surveillance Modeling Network.

Issaka, R. B., Matrajt, L., de Lima, P. N., & Rutter, C. M. (2025). Modeled Cost-Effectiveness of a Rideshare Program to Facilitate Colonoscopy Completion. JAMA network open, 8(9), e2530515.