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Cross-sectional adherence with the multi-target stool DNA test for colorectal cancer screening in a large, nationally insured cohort.

Authors
  • Miller-Wilson, Lesley-Ann1
  • Rutten, Lila J Finney2
  • Van Thomme, Jack1
  • Ozbay, A Burak1
  • Limburg, Paul J3
  • 1 Exact Sciences Corporation, Madison, WI, USA.
  • 2 Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
  • 3 Mayo Clinic, 200 First Street SW, Rochester, MN, USA. [email protected]
Type
Published Article
Journal
International Journal of Colorectal Disease
Publisher
Springer-Verlag
Publication Date
Nov 01, 2021
Volume
36
Issue
11
Pages
2471–2480
Identifiers
DOI: 10.1007/s00384-021-03956-0
PMID: 34019124
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Colorectal cancer (CRC) is the second most deadly cancer in the USA. Early detection can improve CRC outcomes, but recent national screening rates (62%) remain below the 80% goal set by the National Colorectal Cancer Roundtable. Multiple options are endorsed for average-risk CRC screening, including the multi-target stool DNA (mt-sDNA) test. We evaluated cross-sectional mt-sDNA test completion in a population of commercially and Medicare-insured patients. Participants included individuals ages 50 years and older with commercial insurance or Medicare, with a valid mt-sDNA test shipped by Exact Sciences Laboratories LLC between January 1, 2018, and December 31, 2018 (n = 1,420,460). In 2020, we analyzed cross-sectional adherence, as the percent of successfully completed tests within 365 days of shipment date. Overall cross-sectional adherence was 66.8%. Adherence was 72.1% in participants with Traditional Medicare, 69.1% in participants with Medicare Advantage, and 61.9% in participants with commercial insurance. Adherence increased with age: 60.8% for ages 50-64, 71.3% for ages 65-75, and 74.7% for ages 76 + years. Participants with mt-sDNA tests ordered by gastroenterologists had a higher adherence rate (78.3%) than those with orders by primary care clinicians (67.2%). Geographically, adherence rates were highest among highly rural patients (70.8%) and ordering providers in the Pacific region (71.4%). Data from this large, national sample of insured patients demonstrate high cross-sectional adherence with the mt-sDNA test, supporting its role as an accepted, noninvasive option for average-risk CRC screening. Attributes of mt-sDNA screening, including home-based convenience and accompanying navigation support, likely contributed to high completion rates. © 2021. The Author(s).

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