Adherence to Multitarget Stool DNA Testing in Individuals Aged 45-49 Years With Average Risk for Colorectal Cancer

Recommendations for colorectal cancer (CRC) screening have been updated to include individuals aged 45-49 years, addressing recent increases in CRC rates among young adults. The multitarget stool DNA (mt-sDNA) test is approved for average-risk individuals aged 45-49 years and is a noninvasive, at-home, stool-based option. This real-world study quantified mt-sDNA screening adherence rates for individuals aged 45-49 years.

This was a retrospective analysis of individuals aged 45-49 years with average risk for CRC and no history of mt-sDNA testing. Individuals received an mt-sDNA test kit based on a point-of-care order. Adherence was defined as the return of a kit resulting in a valid test result within 1 year of prescription.

A total of 1,126,523 individuals were included. Most (58.6%) were female, and 62.2% received digital communications about the test through text message only. Overall, 68.9% returned their mt-sDNA kit within 1 year. Across provider types, adherence was highest for individuals who were prescribed the test by a gastroenterologist (75.5%); among payor types, adherence was highest for those enrolled in commercial insurance (70.9%). Adherence was lowest for individuals who did not receive any digital communications (54.9%) vs those who did. In a logistic regression analysis, digital communication and payor type were the strongest predictors of adherence.

In this large real-world study, 68.9% of individuals aged 45-49 years returned an mt-sDNA CRC screening test within 1 year. Increasing digital communication may improve mt-sDNA screening adherence.