Adherence to Repeat Screening Completion for Colorectal Cancer Using the Multi-Target Stool DNA Test: Real-World...

Area of Science:

• Oncology
• Genetics
• Public Health

Background:

• Colorectal cancer screening is crucial for early detection and improved outcomes.
• Multi-target stool DNA (mt-sDNA) testing offers a non-invasive option for colorectal cancer screening.
• Understanding adherence to repeat mt-sDNA screening is vital for optimizing population-level screening strategies.

Purpose of the Study:

• To evaluate real-world adherence to repeat multi-target stool DNA (mt-sDNA) screening.
• To analyze adherence rates across different payer types and within federally qualified health centers (FQHCs) in the US.
• To identify factors influencing repeat mt-sDNA screening completion.

Main Methods:

• Retrospective analysis of de-identified data from Exact Sciences Laboratories, LLC (January 1, 2023 – December 31, 2023).
• Inclusion criteria: patients who previously completed an mt-sDNA test.
• Outcomes measured: repeat mt-sDNA screening adherence rate and time to test return.

Main Results:

• A total of 19,536 eligible patients were included in the study.
• The overall mt-sDNA repeat screening adherence rate was 79.7%.
• Significant variations in adherence were observed based on insurance type (Medicare: 84.7%, Medicaid: 65.9%, P < .001), with Medicaid patients having 42% lower odds of adherence compared to commercially insured patients. Patients with more prior successful tests showed quicker return times.

Conclusions:

• Repeat mt-sDNA screening adherence is generally high but demonstrates disparities based on insurance coverage.
• Insurance type and the number of previous successful screenings are significant predictors of adherence.
• Targeted interventions may be necessary to improve repeat screening rates among underrepresented patient groups, particularly those with Medicaid coverage.