Association Between Spanish-Language Patient Navigation and Adherence to Multi-Target Stool DNA Testing Among...

Colorectal cancer (CRC) screening rates remain low among Spanish-speaking populations, in part due to language barriers. This study examined the association between Spanish-language patient navigation on adherence to multi-target stool DNA (mt-sDNA) testing among Spanish-speaking patients at Sanitas Medical Center (SMC). This retrospective analysis utilized data from Exact Sciences Laboratories LLC. It included Spanish-speaking individuals aged 45 to 75 years who received an mt-sDNA test kit between October 1, 2021, and August 1, 2022. Patients were categorized based on Spanish-language outreach (SLO) or English-language outreach (ELO). Adherence was defined as the percentage of kits that were returned with completed tests and successful results within 365 days of the initial shipment date. Chi-square tests and multivariable logistic regression were used to compare adherence between groups and identify factors associated with adherence. The final sample included 3,101 patients in the SLO group and 1,331 in the ELO group. The SLO group showed a 4.4% absolute increase in adherence compared to the ELO group (64.3% vs. 59.9%, p = 0.006). At 30 days, adherence was already higher among SLO patients (45.1% vs. 41.5%), and this difference persisted throughout the 12-month follow-up period. The increase in adherence was consistent across subgroups, including patients aged 50-64 years (64.4% vs. 58.5%, p = 0.002), males (62.2% vs. 55.5%, p = 0.008), and those seen by primary care providers (64.9% vs. 59.8%, p = 0.029). In adjusted logistic regression, SLO was associated with 20% higher odds of adherence compared to ELO (OR = 1.20, 95% CI 1.05-1.37, p = 0.007). Spanish-language patient navigation was associated with a 4.4% higher adherence to mt-sDNA CRC screening among Spanish-speaking patients. These findings suggest that culturally and linguistically tailored communication may support improved screening participation in underserved populations.