Gohil Shrey, D'Attilio Daniel, Paladiya Ruchir, Ganguly Arup, Vergara Cunegundo Manuel, Karlitz Jordan J, Greene Mallik
Exact Sciences Corporation, 5505 Endeavor Ln, Madison, WI, 53719, USA.
Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA.
Int J Colorectal Dis. 2025 Sep 16;40(1):200. doi: 10.1007/s00384-025-04997-5.
The multi-target stool DNA (mt-sDNA) test is a growing and convenient option for colorectal cancer (CRC) screening. Adherence to screening is critical to optimize patient outcomes. This study aimed to evaluate real-world adherence to mt-sDNA testing and the rate of follow-up colonoscopy after positive results among average-risk patients within a large regional health system.
This retrospective cohort study included patients aged 45-75 years in the Hartford HealthCare system whose provider ordered an mt-sDNA test between August 2014 and May 2023. Those at high risk of CRC were excluded. Adherence was defined as the return of a successfully completed test with valid results within 365 days of shipment. Rates of and time to follow-up colonoscopy were assessed in mt-sDNA-positive patients. Logistic regression assessed characteristics associated with adherence.
Of 24,945 included patients, 96.8% had never previously taken an mt-sDNA test and 60.5% were female. Overall, 17,240 patients (69.1%) adhered to the mt-sDNA test. Younger adults aged 45-49 years had high adherence (74.0%). Logistic regression found age 45-49 years, income > $75K, history of mt-sDNA adherence, and seeing a gastrointestinal specialist were predictors of greater adherence. Of 2,468 patients (14.3%) with positive test results, 1,686 (68.3%) had follow-up colonoscopies within a year, and 1,322 (53.6%) within 4 months, of the test result.
In this regional health system, nearly 70% of patients adhered to mt-sDNA testing. Among those with positive results, 68.3% completed follow-up colonoscopies. These findings highlight the potential utility of mt-sDNA testing in supporting CRC screening and follow-up in certain clinical settings.
mt-sDNA testing may support improved CRC screening adherence and timely follow-up in certain health care settings.
多靶点粪便DNA（mt-sDNA）检测是一种日益普及且便捷的结直肠癌（CRC）筛查方法。坚持筛查对于优化患者预后至关重要。本研究旨在评估在一个大型区域卫生系统中，平均风险患者对mt-sDNA检测的实际依从性以及检测结果呈阳性后的后续结肠镜检查率。
这项回顾性队列研究纳入了哈特福德医疗保健系统中年龄在45至75岁之间、其医疗服务提供者在2014年8月至2023年5月期间开具了mt-sDNA检测医嘱的患者。排除结直肠癌高风险患者。依从性定义为在样本寄出后365天内返回一份成功完成且结果有效的检测报告。对mt-sDNA检测结果呈阳性的患者进行后续结肠镜检查的比例和时间进行了评估。逻辑回归分析评估了与依从性相关的特征。
在纳入的24,945例患者中，96.8%此前从未进行过mt-sDNA检测，60.5%为女性。总体而言，17,240例患者（69.1%）坚持进行了mt-sDNA检测。45至49岁的年轻成年人依从性较高（74.0%）。逻辑回归分析发现，年龄在45至49岁、收入超过75,000美元、有mt-sDNA检测依从史以及看过胃肠专科医生是更高依从性的预测因素。在2,468例（14.3%）检测结果呈阳性的患者中，1,686例（68.3%）在检测结果出来后的一年内进行了后续结肠镜检查，1,322例（53.6%）在4个月内进行了检查。
在这个区域卫生系统中，近70%的患者坚持进行了mt-sDNA检测。在检测结果呈阳性的患者中，68.3%完成了后续结肠镜检查。这些发现凸显了mt-sDNA检测在某些临床环境中支持CRC筛查及后续跟进的潜在效用。
mt-sDNA检测可能有助于在某些医疗环境中提高CRC筛查的依从性并及时进行后续跟进。
