Greene Mallik, Pew Timo, Gohil Shrey, Ozbay A Burak, Lopez Juliana, Limburg Paul, Duarte Martha
Exact Sciences Corporation, Madison, WI, USA.
Unisanitas, Bogotá, Cundinamarca, Colombia.
Curr Med Res Opin. 2025 Jun 2:1-9. doi: 10.1080/03007995.2025.2508764.
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.
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.
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 ( = 0.004); patients who received SMS and email had a 59% higher likelihood of adherence than patients with no digital outreach ( < 0.001).
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.
英语水平有限可能会阻碍美国讲西班牙语的人群完成结直肠癌（CRC）筛查。本研究评估了使用带有西班牙语导航的多靶点粪便DNA（mt-sDNA）检测进行CRC再次筛查的依从性，以及与再次筛查依从性相关的患者特征。
使用了Exact Sciences Laboratories, LLC（2023年1月1日至2023年12月31日）的数据。纳入研究期间收到mt-sDNA检测试剂盒、表明西班牙语为其首选语言且在≥2.5年前完成mt-sDNA筛查且结果为阴性的有保险患者（45 - 75岁）。比较了不同支付方类型之间的再次筛查依从性和检测返回的平均时间；使用回归模型确定这些结果与患者特征之间的关系。
在8651名患者中（45 - 64岁：58.9%；女性：59.），仅通过短信进行部分数字化 outreach是最常见的 outreach类型。再次筛查依从性为80.4%，通过管理式医疗组织投保的患者中该比例在数值上最高（83.7%）。从mt-sDNA试剂盒发货到收到有效检测结果的总体平均（标准差）时间为26.6（38.2）天（不同支付方类型的范围：26.1 [38.9] - 29.8 [41.5]）。医疗保险患者的依从可能性比商业保险患者高42%（ = 0.004）；收到短信和电子邮件的患者的依从可能性比没有数字化 outreach的患者高59%（ < 0.001）。
在选择西班牙语作为首选语言的患者中，所有支付方类型使用带有西班牙语导航的mt-sDNA检测的再次筛查依从性都很高，为80.4%。
