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Purpose <p>Adherence to colorectal cancer (CRC) re-screening is essential to maximize screening effectiveness. This study assessed adherence to a multi-target stool DNA (mt-sDNA) test among previous users in the USA across different payer types.</p> Methods <p>Data from Exact Sciences Laboratories LLC (01/01/2023–12/31/2023) were used. Insured patients (45–85&#xa0;years) who were shipped an mt-sDNA test during the data coverage period and had previously completed mt-sDNA screening with a negative result ≥ 2.5&#xa0;years prior were included. Mt-sDNA re-screening adherence rate and mean time to test return were compared across payer types, and their associations with patient characteristics were assessed using multivariable regression models.</p> Results <p>Of 793,567 patients (50–75&#xa0;years: 89.0%; female: 62.0%), the re-screening adherence rate was 84.0% (from 66.5% for Medicaid to 90.2% for Medicare); mean (standard deviation) time to test return was 20.7 (20.8) days (from 19.2 [19.7] for Medicare to 22.4 [22.2] for Medicaid). Characteristics associated with higher likelihood of re-screening adherence included older ages (odds ratio [OR] = 1.25 and 1.11 for 65–75 and 76–85&#xa0;years, respectively, relative to 45–49&#xa0;years), living in a ZIP code with higher median household income (OR = 1.80 for &gt; $200,000 relative to &lt; $50,000), full digital outreach (OR = 1.84 relative to no digital outreach), and ≥ 3rd rounds of screening (OR = 2.44 relative to 2nd round of screening).</p> Conclusion <p>Adherence to CRC re-screening with mt-sDNA test was high across payer types, with sustained adherence in later rounds of screening. Strategies to improve re-screening rates in subgroups associated with lower re-screening adherence are warranted.</p>

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Re-screening adherence to multi-target stool DNA test for colorectal cancer: real-world study in a large national population

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月24日

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  • Mallik Greene,
  • Timo Pew,
  • Michael Dore,
  • Derek W. Ebner,
  • A. Burak Ozbay,
  • William K. Johnson,
  • John B. Kisiel,
  • A. Mark Fendrick,
  • Paul Limburg

摘要

Purpose

Adherence to colorectal cancer (CRC) re-screening is essential to maximize screening effectiveness. This study assessed adherence to a multi-target stool DNA (mt-sDNA) test among previous users in the USA across different payer types.

Methods

Data from Exact Sciences Laboratories LLC (01/01/2023–12/31/2023) were used. Insured patients (45–85 years) who were shipped an mt-sDNA test during the data coverage period and had previously completed mt-sDNA screening with a negative result ≥ 2.5 years prior were included. Mt-sDNA re-screening adherence rate and mean time to test return were compared across payer types, and their associations with patient characteristics were assessed using multivariable regression models.

Results

Of 793,567 patients (50–75 years: 89.0%; female: 62.0%), the re-screening adherence rate was 84.0% (from 66.5% for Medicaid to 90.2% for Medicare); mean (standard deviation) time to test return was 20.7 (20.8) days (from 19.2 [19.7] for Medicare to 22.4 [22.2] for Medicaid). Characteristics associated with higher likelihood of re-screening adherence included older ages (odds ratio [OR] = 1.25 and 1.11 for 65–75 and 76–85 years, respectively, relative to 45–49 years), living in a ZIP code with higher median household income (OR = 1.80 for > $200,000 relative to < $50,000), full digital outreach (OR = 1.84 relative to no digital outreach), and ≥ 3rd rounds of screening (OR = 2.44 relative to 2nd round of screening).

Conclusion

Adherence to CRC re-screening with mt-sDNA test was high across payer types, with sustained adherence in later rounds of screening. Strategies to improve re-screening rates in subgroups associated with lower re-screening adherence are warranted.