Cytryn Edward, Stauber Zachary, Jaeckel Kayla, Barai Nikita, White Pascale, Wang Christina P, Fishman Mary, Wisnivesky Juan P, Jandorf Lina H, Itzkowitz Steve H, Koster Kyle M
Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Ambulatory Care, The Mount Sinai Hospital, New York, NY, USA.
J Gen Intern Med. 2025 Mar;40(4):935-940. doi: 10.1007/s11606-024-09201-y. Epub 2024 Nov 18.
Multitarget stool DNA (mt-sDNA) is an increasingly utilized noninvasive option for colorectal cancer screening; however, its impact is limited by imperfect test adherence. Tailored patient navigation (TPN) improves adherence for other cancer screening tests, but its role in mt-sDNA is not known.
Determine whether TPN improves mt-sDNA completion and reduces sample could not be processed (SCNBP) result rates.
A large, urban, academic primary care clinic serving a medically vulnerable population.
All patients who received mt-sDNA order in 2022 and 2023.
A patient navigator outreached all patients ordered mt-sDNA to support test completion during the 12-month intervention period in 2023.
Rates of mt-sDNA completion within 90 days and SCNBP results were compared between the 12-month intervention and pre-intervention periods using generalized estimating equations. A total of 2694 patients received 3297 orders during the study. TPN was significantly associated with improved rates of 90-day mt-sDNA completion (51% vs. 39%, OR 1.67, p < .001) and SCNBP results (4% vs. 5%, OR 0.55, p < .001).
Tailored patient navigation was associated with improved rates of mt-sDNA completion and SCNBP results despite built-in navigation services provided by the manufacturer. TPN for mt-sDNA is a promising strategy for enhancing colorectal cancer screening uptake.
多靶点粪便DNA（mt-sDNA）是一种在结直肠癌筛查中越来越常用的非侵入性方法；然而，其效果受到检测依从性欠佳的限制。个性化患者导航（TPN）可提高其他癌症筛查检测的依从性，但其在mt-sDNA检测中的作用尚不清楚。
确定TPN是否能提高mt-sDNA检测的完成率，并降低无法处理样本（SCNBP）的结果率。
一家为医疗弱势群体服务的大型城市学术初级保健诊所。
2022年和2023年所有接受mt-sDNA检测医嘱的患者。
在2023年为期12个月的干预期内，一名患者导航员联系了所有接受mt-sDNA检测医嘱的患者，以支持检测的完成。
使用广义估计方程比较了12个月干预期和干预前期90天内mt-sDNA检测的完成率以及SCNBP结果。在研究期间，共有2694名患者接受了3297次检测医嘱。TPN与90天mt-sDNA检测完成率的提高（51%对39%，OR 1.67，p < 0.001）和SCNBP结果的改善（4%对5%，OR 0.55，p < 0.001）显著相关。
尽管制造商提供了内置的导航服务，但个性化患者导航与mt-sDNA检测完成率的提高和SCNBP结果的改善相关。mt-sDNA检测的TPN是提高结直肠癌筛查接受率的一种有前景的策略。
