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

INTRODUCTION

Guidelines recommend starting average-risk colorectal cancer (CRC) screening at age 45 years, and thereafter repeating screening tests at regular intervals. However, US screening rates are currently suboptimal. This study evaluated adherence to repeat CRC screening with the non-invasive multi-target stool DNA (mt-sDNA) test among US adults.

METHODS

This was a retrospective claims-based analysis of individuals aged 45-75 years at average risk for CRC who had previously completed the mt-sDNA test. Individuals received the repeat mt-sDNA kit based on a point-of-care order. The primary outcome was adherence, defined as the return of a kit with a valid result within 1 year. Secondary outcomes included rates of follow-up colonoscopy.

RESULTS

The analysis included 352,253 patients. Most patients were female (62.1%), White (60.9%), had no comorbidities (76.5%), and underwent one earlier mt-sDNA test (98.1%). Overall adherence for repeat screening was 86.2%. In logistic regression analysis, higher household income ($100,000-$200,000: 2.05; 1.49-2.77; > $200,000: 2.46; 1.75-3.40; both vs. < $25,000) and receipt of digital outreach (1.36; 1.33-1.40 vs. no digital communications) were associated with higher adherence to repeat screening. Mean (95% CI) time to a successful result was 35.6 (35.4-35.7) days. Among patients who tested positive, 75.8% underwent colonoscopy.

CONCLUSIONS

In this large real-world study, adherence to repeat screening with the mt-sDNA test was high. These findings underscore the effectiveness of the mt-sDNA test in improving CRC screening adherence.