Real-world repeat screening adherence to multi-target stool DNA for colorectal cancer in a large, national Spanish-speaking population.

Background: Limited English proficiency may hinder completion of colorectal cancer (CRC) screening in Spanish speakers in the US. This study evaluated CRC re-screening adherence using the multi-target stool DNA (mt-sDNA) test with Spanish language navigation, and patient characteristics associated with re-screening adherence.

Methods: Data from Exact Sciences Laboratories, LLC (1 January 2023-31 December 2023) were used. Patients (45-75 years) with insurance who were shipped an mt-sDNA test during the study period, indicated Spanish as their preferred language, and had completed mt-sDNA screening with a negative result ≥2.5 years prior were included. Re-screening adherence and mean time to test return were compared among payer types; regression models were used to determine the relationship between these outcomes and patient characteristics.

Results: Among 8,651 patients (45-64 years: 58.9%; female: 59.0%), partial digital with SMS only (46.3%) was the most frequent outreach type. Re-screening adherence was 80.4%, with the numerically highest rates in patients insured through managed care organizations (83.7%). Mean (standard deviation) overall time to test return from the shipment of the mt-sDNA kit to receipt of a valid test was 26.6 (38.2) days (range across payer types: 26.1 [38.9]-29.8 [41.5]). Medicare patients had a 42% higher likelihood of adherence than commercially insured patients (p = 0.004); patients who received SMS and email had a 59% higher likelihood of adherence than patients with no digital outreach (p < 0.001).

Conclusion: Re-screening adherence of the mt-sDNA tests with Spanish language navigation was high, at 80.4%, across all payer types in patients selecting Spanish as their preferred language.