Blood Test Increases Colorectal Cancer Screening in Persons Who Declined Colonoscopy and Fecal Immunochemical Test: A...

Area of Science:

• Oncology
• Preventive Medicine
• Biomarkers

Background:

• Colorectal cancer (CRC) screening is crucial for early detection and prevention.
• The septin 9 blood test is an option for individuals declining first-line CRC screening methods.
• Participation rates for second-line screening options remain unclear.

Purpose of the Study:

• To evaluate the effectiveness of offering a septin 9 blood test as a secondary option for CRC screening.
• To compare screening completion rates between standard outreach and outreach including a blood test option.
• To assess the impact on both any screening and a full screening strategy.

Main Methods:

• A randomized controlled trial was conducted with screen-eligible Veterans aged 50-75.
• Participants had previously declined colonoscopy and fecal immunochemical test (FIT).
• The intervention group received outreach offering colonoscopy/FIT plus the blood test, while the control group received standard colonoscopy/FIT outreach.

Main Results:

• Overall screening completion increased by 7.5% in the intervention group compared to the control group (P = .035).
• Uptake of colonoscopy and FIT remained similar between groups.
• Completion of a full screening strategy, including follow-up colonoscopy, did not significantly differ (P = .084).

Conclusions:

• Offering a septin 9 blood test as a secondary option can improve CRC screening participation.
• The blood test shows promise for increasing initial screening uptake without cannibalizing first-line test usage.
• Challenges persist in ensuring timely colonoscopy completion after a positive noninvasive test result.