Cross-sectional adherence with the multi-target stool DNA test for colorectal cancer screening in a medicaid population
Colorectal cancer (CRC) is the third leading cause of cancer death in the US. Early detection improves CRC outcomes and multiple options are endorsed for CRC screening; however, adherence remains challenging. Among Medicaid enrollees, the fecal immunochemical test (FIT) is often used for average-ris...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-12-01
|
| Series: | Preventive Medicine Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335522003394 |
| _version_ | 1797985271517544448 |
|---|---|
| author | Lesley-Ann Miller-Wilson Lila J. Finney Rutten Jack Van Thomme A. Burak Ozbay Jennifer Laffin Paul Limburg |
| author_facet | Lesley-Ann Miller-Wilson Lila J. Finney Rutten Jack Van Thomme A. Burak Ozbay Jennifer Laffin Paul Limburg |
| author_sort | Lesley-Ann Miller-Wilson |
| collection | DOAJ |
| description | Colorectal cancer (CRC) is the third leading cause of cancer death in the US. Early detection improves CRC outcomes and multiple options are endorsed for CRC screening; however, adherence remains challenging. Among Medicaid enrollees, the fecal immunochemical test (FIT) is often used for average-risk CRC screening, with suboptimal adherence rates reported (12.3–23.2 %). The navigation-supported (personalized outreach by phone, mail, email and text), at home collection, multi-target stool DNA (mt-sDNA) test represents a relatively recent and broadly accessible option for average-risk CRC screening in Medicaid enrollees. We assessed cross-sectional mt-sDNA adherence in a national sample of Medicaid patients. Data from Exact Sciences Laboratories LLC (ESL; Madison, WI) were retrospectively analyzed. Participants included individuals 45 + years covered by Fee-For-Service (FFS)- or Managed-Medicaid. Primary analysis focused on the 50–74 age cohort and included those with valid mt-sDNA orders between January 1–December 31, 2018. Data from 25,794 individuals who received valid orders for mt-sDNA were included in analysis (61.2 % women; mean age at order 57.5 years). Overall adherence – completion of an ordered test – was 51.3 %. Adherence was 54.6 % in Managed-Medicaid and 38.9 % in FFS-Medicaid. Adherence by age was: 51.5 % for 50–64 years and 47.7 % for 65–74 years. Mt-sDNA tests ordered by gastroenterologists had higher adherence (60.5 %) compared with primary care clinicians (51.3 %). These data from a large, national sample of Medicaid-insured patients substantiate mt-sDNA testing as a viable patient-supported, home-based option to improve average-risk CRC screening participation in Medicaid enrollees. |
| first_indexed | 2024-04-11T07:14:32Z |
| format | Article |
| id | doaj.art-580481608d5448228e7c37fc5af9f373 |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-04-11T07:14:32Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-580481608d5448228e7c37fc5af9f3732022-12-22T04:38:02ZengElsevierPreventive Medicine Reports2211-33552022-12-0130102032Cross-sectional adherence with the multi-target stool DNA test for colorectal cancer screening in a medicaid populationLesley-Ann Miller-Wilson0Lila J. Finney Rutten1Jack Van Thomme2A. Burak Ozbay3Jennifer Laffin4Paul Limburg5Exact Sciences Corporation, 5505 Endeavor Lane, Madison, WI 53719, United States; Corresponding author at: Exact Sciences Corporation, Sr Dir, Health Economics & Outcomes Research, 5505 Endeavor Lane, Madison, WI 53719, United States.Exact Sciences Corporation, 5505 Endeavor Lane, Madison, WI 53719, United States; Mayo Clinic, 200 1st St SW, Rochester, MN 55905, United StatesExact Sciences Corporation, 5505 Endeavor Lane, Madison, WI 53719, United StatesExact Sciences Corporation, 5505 Endeavor Lane, Madison, WI 53719, United StatesExact Sciences Corporation, 5505 Endeavor Lane, Madison, WI 53719, United StatesExact Sciences Corporation, 5505 Endeavor Lane, Madison, WI 53719, United StatesColorectal cancer (CRC) is the third leading cause of cancer death in the US. Early detection improves CRC outcomes and multiple options are endorsed for CRC screening; however, adherence remains challenging. Among Medicaid enrollees, the fecal immunochemical test (FIT) is often used for average-risk CRC screening, with suboptimal adherence rates reported (12.3–23.2 %). The navigation-supported (personalized outreach by phone, mail, email and text), at home collection, multi-target stool DNA (mt-sDNA) test represents a relatively recent and broadly accessible option for average-risk CRC screening in Medicaid enrollees. We assessed cross-sectional mt-sDNA adherence in a national sample of Medicaid patients. Data from Exact Sciences Laboratories LLC (ESL; Madison, WI) were retrospectively analyzed. Participants included individuals 45 + years covered by Fee-For-Service (FFS)- or Managed-Medicaid. Primary analysis focused on the 50–74 age cohort and included those with valid mt-sDNA orders between January 1–December 31, 2018. Data from 25,794 individuals who received valid orders for mt-sDNA were included in analysis (61.2 % women; mean age at order 57.5 years). Overall adherence – completion of an ordered test – was 51.3 %. Adherence was 54.6 % in Managed-Medicaid and 38.9 % in FFS-Medicaid. Adherence by age was: 51.5 % for 50–64 years and 47.7 % for 65–74 years. Mt-sDNA tests ordered by gastroenterologists had higher adherence (60.5 %) compared with primary care clinicians (51.3 %). These data from a large, national sample of Medicaid-insured patients substantiate mt-sDNA testing as a viable patient-supported, home-based option to improve average-risk CRC screening participation in Medicaid enrollees.http://www.sciencedirect.com/science/article/pii/S2211335522003394mt-sDNAMedicaidInsuranceColorectal cancer screeningCancer preventionEarly cancer detection |
| spellingShingle | Lesley-Ann Miller-Wilson Lila J. Finney Rutten Jack Van Thomme A. Burak Ozbay Jennifer Laffin Paul Limburg Cross-sectional adherence with the multi-target stool DNA test for colorectal cancer screening in a medicaid population Preventive Medicine Reports mt-sDNA Medicaid Insurance Colorectal cancer screening Cancer prevention Early cancer detection |
| title | Cross-sectional adherence with the multi-target stool DNA test for colorectal cancer screening in a medicaid population |
| title_full | Cross-sectional adherence with the multi-target stool DNA test for colorectal cancer screening in a medicaid population |
| title_fullStr | Cross-sectional adherence with the multi-target stool DNA test for colorectal cancer screening in a medicaid population |
| title_full_unstemmed | Cross-sectional adherence with the multi-target stool DNA test for colorectal cancer screening in a medicaid population |
| title_short | Cross-sectional adherence with the multi-target stool DNA test for colorectal cancer screening in a medicaid population |
| title_sort | cross sectional adherence with the multi target stool dna test for colorectal cancer screening in a medicaid population |
| topic | mt-sDNA Medicaid Insurance Colorectal cancer screening Cancer prevention Early cancer detection |
| url | http://www.sciencedirect.com/science/article/pii/S2211335522003394 |
| work_keys_str_mv | AT lesleyannmillerwilson crosssectionaladherencewiththemultitargetstooldnatestforcolorectalcancerscreeninginamedicaidpopulation AT lilajfinneyrutten crosssectionaladherencewiththemultitargetstooldnatestforcolorectalcancerscreeninginamedicaidpopulation AT jackvanthomme crosssectionaladherencewiththemultitargetstooldnatestforcolorectalcancerscreeninginamedicaidpopulation AT aburakozbay crosssectionaladherencewiththemultitargetstooldnatestforcolorectalcancerscreeninginamedicaidpopulation AT jenniferlaffin crosssectionaladherencewiththemultitargetstooldnatestforcolorectalcancerscreeninginamedicaidpopulation AT paullimburg crosssectionaladherencewiththemultitargetstooldnatestforcolorectalcancerscreeninginamedicaidpopulation |