Work

Adherence to multi-target stool DNA test and time to follow-up colonoscopy: real-world analysis of patients from the Beth Israel Lahey Health

Year: 2025

Type: article

Abstract: OBJECTIVE: Colorectal cancer (CRC) remains a leading cause of cancer-related mortality in the United States, and screening participation continues to fall short of national targets. Multitarget stool DNA (mt-sDNA) testing provides a noninvasive option shown to promote high adherence, but real-world data within integrated health systems are limited. This study evaluated mt-sDNA test adherence, positivity rates, and time to follow-up colonoscopy (FU-CY) completion, and identified factors associated with adherence to CRC screening within the Beth Israel Lahey Health (BILH) system. METHODS: A retrospective analysis was conducted linking the Komodo Health Claims Database and Exact Sciences Laboratory database, including average-risk adults aged 45-75 who received mt-sDNA orders from 2016 to 2023 at BILH. Outcomes included adherence to mt-sDNA screening, positivity rate, and FU-CY after positive results. RESULTS: Of 31,837 patients with test orders, 76.8% completed the mt-sDNA screening, 11.9% had positive results, and 77.5% of those with positive results completed a FU-CY. Adherence was highest among ages 65-75 (78.9%) and 45-49 (78.2%), the latter showing the lowest positivity (5.37%) but the highest FU-CY (86.61%). Asian or Pacific Islander patients had a high adherence (80.9%). Patients with > 1 prior mt-sDNA had the highest adherence (87.7%) and a FU-CY rate of (78.8%). Medicare (81.0%) and Medicare Advantage (79.3%) patients showed the highest adherence, while commercially insured patients had the highest FU-CY completion (82.0%). CONCLUSION: This large real-world analysis supports mt-sDNA as an effective and accessible CRC screening tool, demonstrating high adherence and timely FU-CY completion across diverse demographic and payer subgroups.

Source: Current Medical Research and Opinion

DOI: 10.1080/03007995.2025.2589536