2024/10/01 by Quang A. Le, Quang Le, Mallik Greene +7
Medicine · #Colorectal Cancer Screening and Detection
paper · doi:10.14309/01.ajg.0001031076.70683.4b
Introduction: The multi-target stool DNA test (mt-sDNA) is a guideline-recommended, at-home CRC screening option for average-risk individuals. Previously reported cross-sectional adherence to mt-sDNA in a population of commercially and Medicare-insured patients was 66.8%, but the rates in the expanded screening population (following the inclusion of individuals aged 45-49 years) is incompletely defined. The objectives of the study are to update cross-sectional adherence to mt-sDNA testing and to evaluate the adherence rates for different payors and sub-groups. Methods: This analysis included individuals between ages 45 and 85 years with commercial, Medicaid, or Medicare insurance and shipped an mt-sDNA test by Exact Sciences Laboratories between January 1, 2023, and June 1, 2023. Patient adherence to mt-sDNA is defined as completion and return of the mt-sDNA test kit within 365 days from the initial shipment. Results: Of 2,142,469 individuals who received a mt-sDNA test kit, overall cross-sectional adherence was 71.2% with an average of 27.3 days from initial shipment date to return of the mt-sDNA test kit. Adherence rates for Medicare, Medicare Advantage, commercial insurance, and Medicaid were 70.1%, 70.1%, 71.2%, and 51.5%, respectively. For age groups 45-49, 50-64, 65-75, and 76-85 years, adherence rates were 69.0%, 68.2%, 73.2%, and 77.3%, respectively. Patients with the highest adherence rates were those who received fully digital outreach, whose mt-sDNA tests were ordered by gastroenterologists, who were Spanish speaking, or who were new or returning to mt-sDNA testing (73.4%, 80.8%, 69.4%, 71.6% and 87.0%, respectively). Conclusion: Data from this large, national sample of insured individuals ages 45-85 years demonstrates high mt-sDNA adherence rates overall and across different health payors and other analyzed subgroups.