Adherence to Repeat Screening Completion for Colorectal Cancer Using the Multi-Target Stool DNA Test: Real-World Analysis of Patients from Federally Qualified Health Centers.

Abstract

This real-world study examined adherence to repeat mt-sDNA among patients from federally qualified health centers (FQHCs) across the US and among different payer types. Data from Exact Sciences Laboratories, LLC were used for the period between January 1, 2023, and December 31, 2023, for those who had previously completed a mt-sDNA test. Study outcomes included adherence rate to mt-sDNA repeat screening and time to test return. The study sample consisted of 19 536 eligible patients. The mt-sDNA repeat screening adherence rate was 79.7%, and the mean time to return the kit was 21.1 ± 20.8 days. Repeat screening adherence for patients with Medicare was 84.7%, Medicare Advantage was 80%, commercial insurance was 78.2%, managed care organization was 74.6%, and Medicaid was 65.9% (<i>P</i> < .001). Compared with patients covered by commercial insurance, those covered by Medicaid had 42% lower odds of adhering to mt-sDNA repeat screening. Patients with 2 or more prior successful tests had a numerically shorter mean time to test return compared to those with only 1 prior successful test. While repeat screening adherence was generally high across patient demographic categories, there were significant differences by type of insurance coverage and number of prior successful mt-sDNA screenings.