# Real‐World Adherence to Repeat Colorectal Cancer Screening With the Multi‐Target Stool DNA Test in a Large, Insured, and Average‐Risk Population

## TL;DR

This study found that most people in the US follow through with repeat colorectal cancer screening using a non-invasive stool DNA test, especially with higher income and digital outreach.

## Contribution

The study provides real-world evidence of high adherence to repeat mt-sDNA screening in a large insured population.

## Key findings

- Overall adherence to repeat mt-sDNA screening was 86.2% within one year.
- Higher household income and digital outreach were associated with better adherence.
- 75.8% of patients who tested positive underwent follow-up colonoscopy.

## Abstract

Guidelines recommend starting average‐risk colorectal cancer (CRC) screening at age 45 years, and thereafter repeating screening tests at regular intervals. However, US screening rates are currently suboptimal. This study evaluated adherence to repeat CRC screening with the non‐invasive multi‐target stool DNA (mt‐sDNA) test among US adults.

This was a retrospective claims‐based analysis of individuals aged 45–75 years at average risk for CRC who had previously completed the mt‐sDNA test. Individuals received the repeat mt‐sDNA kit based on a point‐of‐care order. The primary outcome was adherence, defined as the return of a kit with a valid result within 1 year. Secondary outcomes included rates of follow‐up colonoscopy.

The analysis included 352,253 patients. Most patients were female (62.1%), White (60.9%), had no comorbidities (76.5%), and underwent one earlier mt‐sDNA test (98.1%). Overall adherence for repeat screening was 86.2%. In logistic regression analysis, higher household income ($100,000–$200,000: 2.05; 1.49–2.77; > $200,000: 2.46; 1.75–3.40; both vs. < $25,000) and receipt of digital outreach (1.36; 1.33–1.40 vs. no digital communications) were associated with higher adherence to repeat screening. Mean (95% CI) time to a successful result was 35.6 (35.4–35.7) days. Among patients who tested positive, 75.8% underwent colonoscopy.

In this large real‐world study, adherence to repeat screening with the mt‐sDNA test was high. These findings underscore the effectiveness of the mt‐sDNA test in improving CRC screening adherence.