Real-World Adherence to Repeat Colorectal Cancer Screening With the Multi-Target Stool DNA Test in a Large, Insured,...

Area of Science:

• Oncology
• Gastroenterology
• Public Health

Background:

• Current US colorectal cancer (CRC) screening rates are suboptimal despite guidelines recommending screening initiation at age 45.
• The non-invasive multi-target stool DNA (mt-sDNA) test offers an alternative for CRC screening.
• Adherence to recommended screening intervals is crucial for effective CRC prevention.

Purpose of the Study:

• To evaluate adherence to repeat CRC screening using the mt-sDNA test in average-risk US adults.
• To identify factors associated with adherence to repeat mt-sDNA screening.
• To assess follow-up colonoscopy rates after positive mt-sDNA screening tests.

Main Methods:

• Retrospective claims-based analysis of 352,253 individuals aged 45-75 years at average CRC risk.
• Included individuals who previously completed an mt-sDNA test and received a repeat kit via point-of-care order.
• Primary outcome was adherence (return of a valid kit within 1 year); secondary outcomes included follow-up colonoscopy rates.

Main Results:

• Overall adherence for repeat mt-sDNA screening was 86.2%.
• Higher household income and receipt of digital outreach were associated with increased adherence.
• Among patients with a positive test, 75.8% completed follow-up colonoscopy.

Conclusions:

• High adherence to repeat screening with the mt-sDNA test was observed in a real-world setting.
• The mt-sDNA test demonstrates effectiveness in enhancing CRC screening adherence.
• These findings support the utility of the mt-sDNA test in improving population-level CRC screening coverage.