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Updated: May 10, 2025
Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
Published on: June 8, 2020
Reducing barriers to colorectal cancer screening via at-home multitarget stool DNA tests
Brittany Strelow1, Hanna Dorff, Cole Gunneson
1Brittany Strelow practices community internal medicine at Mayo Clinic in Rochester, Minn. At the time this article was written, Hanna Dorff, Cole Gunneson, Wade Katula, Jeffrey Pokuta, and Kao Vang were students in the PA program at Mayo Clinic School of Health Sciences in Rochester, Minn. Rachel Olson is faculty in the Center for Learning Innovation at University of Minnesota Rochester in Rochester, Minn. Danielle O'Laughlin practices community internal medicine at Mayo Clinic in Rochester, Minn., and is clinical skills co-director and an assistant professor of medicine at Mayo Clinic School of Health Sciences. B. Strelow was, at the time this article was written, on the Exact Sciences Physician Assistant Advisory Council. The authors have disclosed no other potential conflicts of interest, financial or otherwise.
Background:
Colorectal cancer (CRC) is the second leading cause of cancer deaths in the US, with screening rates at 65% to 70%. This quality improvement project in a Southeast Minnesota health system (SMHS) aimed to enhance CRC screening using multitarget stool DNA (mt-sDNA) test kit delivery.
Methods:
Of 13,561 eligible patients ages 45 to 75 years in the SMHS, 12,032 were offered home delivery of mt-sDNA kits through the electronic patient portal.
Results:
Within 90 days, 1,953 kits (16.2%) were returned, with 158 (8.1%) showing abnormal results, leading to colonoscopy referrals. Communication channels included the electronic portal, postal mail messages, and phone calls.
Conclusion:
Implementing mt-sDNA screening resulted in a 4.13% adherence increase, compared with a 0.04% adherence increase without intervention. However, disparities in return rates revealed unexpected challenges in addressing racial and ethnic disparities, as White patients and native English speakers showed higher return rates.
