Adherence to Multitarget Stool DNA Testing in Individuals Aged 45–49 Years With Average Risk for Colorectal Cancer
Mallik Greene, Mark Camardo, A. Burak Ozbay, Michaël Doré, A. Mark Fendrick, Paul J. Limburg
Abstract
INTRODUCTION: Recommendations for colorectal cancer (CRC) screening have been updated to include individuals aged 45-49 years, addressing recent increases in CRC rates among young adults. The multitarget stool DNA (mt-sDNA) test is approved for average-risk individuals aged 45-49 years and is a noninvasive, at-home, stool-based option. This real-world study quantified mt-sDNA screening adherence rates for individuals aged 45-49 years. METHODS: This was a retrospective analysis of individuals aged 45-49 years with average risk for CRC and no history of mt-sDNA testing. Individuals received an mt-sDNA test kit based on a point-of-care order. Adherence was defined as the return of a kit resulting in a valid test result within 1 year of prescription. RESULTS: A total of 1,126,523 individuals were included. Most (58.6%) were female, and 62.2% received digital communications about the test through text message only. Overall, 68.9% returned their mt-sDNA kit within 1 year. Across provider types, adherence was highest for individuals who were prescribed the test by a gastroenterologist (75.5%); among payor types, adherence was highest for those enrolled in commercial insurance (70.9%). Adherence was lowest for individuals who did not receive any digital communications (54.9%) vs those who did. In a logistic regression analysis, digital communication and payor type were the strongest predictors of adherence. DISCUSSION: In this large real-world study, 68.9% of individuals aged 45-49 years returned an mt-sDNA CRC screening test within 1 year. Increasing digital communication may improve mt-sDNA screening adherence.