Real-world adherence to multi-target stool DNA testing for colorectal cancer screening among average risk Hispanic adults in the United States from 2016 to 2023.

Abstract

Introduction: In the United States (US), (CRC) is the second leading cause of cancer death in the Hispanic population overall. Unfortunately, the CRC screening rate in Hispanics is significantly lower than in White adults. The current study utilized real-world data to examine adherence to CRC screening with the mt-sDNA test in the Hispanic population. Additionally, sociodemographic factors that might influence patient adherence were examined to identify potential adherence barriers.

Methods: This study linked two data sources: Komodo Research Data + MapEnhance Komodo Lab database and the Exact Sciences Laboratories database. Participants were Hispanic individuals aged 45-75 years who were new users of mt-sDNA testing between 2016 and 2023. Logistic regression was used to identify factors associated with adherence to mt-sDNA testing.

Results: In the overall study population (n = 807,611), adherence to mt-sDNA testing was 64.3%. Significant variation in adherence was observed by payer type: Medicaid (53.3%), Managed Care Organization (53.4%), Medicare Advantage (62.3%), Medicare (66.5%), and commercial (66.7%) (p < 0.0001). Logistic regression identified additional factors that were significantly associated with greater adherence: older age, coverage by commercial insurance, residing outside metropolitan areas, prescription for CRC screening from a gastrointestinal doctor, and receiving digital outreach.

Discussion: In this large, national study of combined laboratory and claims data, Hispanic individuals in the US demonstrated an overall adherence rate of 64.3%. Adherence was particularly influenced by older age, testing that was ordered by a GI specialist, and digital outreach. These data support mt-sDNA testing as a promising strategy to improve CRC screening participation among Hispanic individuals.