Impact of Digital Navigation on Screening Adherence With the Multi-Target Stool DNA Test

# Background Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer and the second leading cause of cancer-related deaths in the United States. Screening can prevent CRC by detecting advanced precancerous lesions. Adherence to screening is crucial in reducing CRC disease burden; howe...

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Main Authors: Mallik Greene, Timo Pew, A. Burak Ozbay, John B. Kisiel, A. Mark Fendrick, Paul Limburg
Format: Article
Language:English
Published: Columbia Data Analytics, LLC 2025-05-01
Series:Journal of Health Economics and Outcomes Research
Online Access:https://doi.org/10.36469/001c.133939
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author Mallik Greene
Timo Pew
A. Burak Ozbay
John B. Kisiel
A. Mark Fendrick
Paul Limburg
author_facet Mallik Greene
Timo Pew
A. Burak Ozbay
John B. Kisiel
A. Mark Fendrick
Paul Limburg
author_sort Mallik Greene
collection DOAJ
description # Background Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer and the second leading cause of cancer-related deaths in the United States. Screening can prevent CRC by detecting advanced precancerous lesions. Adherence to screening is crucial in reducing CRC disease burden; however, there is limited research on the impact of digital outreach screening uptake and adherence. # Objective This study evaluated the impact of different digital outreach channels on patient adherence to CRC screening with a multi-target stool DNA (mt-sDNA) test in a real-world setting. # Methods Patients were individuals aged 45 to 85 years with a valid mt-sDNA test order from Exact Sciences Laboratories, LLC (Jan. 1, 2023–Sept. 23, 2023). All patients received letters and phone calls; some received short message service (SMS), email, or both. Adherence and time to test return were compared across digital outreach categories stratified by patient characteristics. Multivariable regression evaluated the association of digital outreach methods with adherence and time to test return. # Results Among 2 425 308 patients (43.5% between 50 and 64 years, 58.2% female), digital SMS only (62.7%) was the most common outreach method. Overall adherence was 70.1%, with highest adherence in the digital SMS-plus-email group (72.9%). Mean time to test return from shipment of mt-sDNA kit to receipt of valid test was 25.8 days. In adjusted analyses, patients receiving digital SMS plus email had the highest odds of test return (odds ratio, 1.75; 95% confidence interval [CI], 1.73-1.78; _P_<.001) and had return times 8.7% shorter than the no-digital-outreach group (95% CI, 8.2-9.2; _P_<.001). # Discussion Among nationally insured individuals within the recommended age range for CRC screening, overall adherence to the mt-sDNA test was in the 70s, with the highest rates in the digital (SMS and email) outreach group and the lowest in the no-digital-outreach group. # Conclusions These findings highlight the importance of multichannel navigation in facilitating completion of CRC screening with the mt-sDNA test.
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spelling doaj-art-0a6f56cb4f3c4c86914960a0cd5d35d12025-08-04T17:58:05ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362025-05-01121Impact of Digital Navigation on Screening Adherence With the Multi-Target Stool DNA TestMallik GreeneTimo PewA. Burak OzbayJohn B. KisielA. Mark FendrickPaul Limburg# Background Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer and the second leading cause of cancer-related deaths in the United States. Screening can prevent CRC by detecting advanced precancerous lesions. Adherence to screening is crucial in reducing CRC disease burden; however, there is limited research on the impact of digital outreach screening uptake and adherence. # Objective This study evaluated the impact of different digital outreach channels on patient adherence to CRC screening with a multi-target stool DNA (mt-sDNA) test in a real-world setting. # Methods Patients were individuals aged 45 to 85 years with a valid mt-sDNA test order from Exact Sciences Laboratories, LLC (Jan. 1, 2023–Sept. 23, 2023). All patients received letters and phone calls; some received short message service (SMS), email, or both. Adherence and time to test return were compared across digital outreach categories stratified by patient characteristics. Multivariable regression evaluated the association of digital outreach methods with adherence and time to test return. # Results Among 2 425 308 patients (43.5% between 50 and 64 years, 58.2% female), digital SMS only (62.7%) was the most common outreach method. Overall adherence was 70.1%, with highest adherence in the digital SMS-plus-email group (72.9%). Mean time to test return from shipment of mt-sDNA kit to receipt of valid test was 25.8 days. In adjusted analyses, patients receiving digital SMS plus email had the highest odds of test return (odds ratio, 1.75; 95% confidence interval [CI], 1.73-1.78; _P_<.001) and had return times 8.7% shorter than the no-digital-outreach group (95% CI, 8.2-9.2; _P_<.001). # Discussion Among nationally insured individuals within the recommended age range for CRC screening, overall adherence to the mt-sDNA test was in the 70s, with the highest rates in the digital (SMS and email) outreach group and the lowest in the no-digital-outreach group. # Conclusions These findings highlight the importance of multichannel navigation in facilitating completion of CRC screening with the mt-sDNA test.https://doi.org/10.36469/001c.133939
spellingShingle Mallik Greene
Timo Pew
A. Burak Ozbay
John B. Kisiel
A. Mark Fendrick
Paul Limburg
Impact of Digital Navigation on Screening Adherence With the Multi-Target Stool DNA Test
Journal of Health Economics and Outcomes Research
title Impact of Digital Navigation on Screening Adherence With the Multi-Target Stool DNA Test
title_full Impact of Digital Navigation on Screening Adherence With the Multi-Target Stool DNA Test
title_fullStr Impact of Digital Navigation on Screening Adherence With the Multi-Target Stool DNA Test
title_full_unstemmed Impact of Digital Navigation on Screening Adherence With the Multi-Target Stool DNA Test
title_short Impact of Digital Navigation on Screening Adherence With the Multi-Target Stool DNA Test
title_sort impact of digital navigation on screening adherence with the multi target stool dna test
url https://doi.org/10.36469/001c.133939
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