P0436 - Gap Closure Adherence to Multi-Targeted Stool DNA Test for Colorectal Cancer Screening in an Insured Cohort

Quang Le, PharmD, PhD¹, Mallik Greene, PhD², Timo Pew, MS², Alisdair R. Philp, PhD, MS³, Will K. Johnson, PhD, MSc¹, A. Burak Ozbay, MBA, PhD⁴, Michael Dore, MD⁵, A Mark Fendrick, MD⁶, Derek W. Ebner, MD⁷, John B. Kisiel, MD⁷, Paul Limburg, MD, MPH^8
1Exact Sciences Corporation, Madison, WI; ²Exact Sciences, Madison, WI; ³Exact Sciences, Weston, MO; ⁴Exact Sciences, Lake Forest, IL; ⁵Durham, NC; ⁶University of Michigan, Ann Arbor, MI; ⁷Mayo Clinic, Rochester, MN; ⁸Exact Sciences, Rochester, MN

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. It is estimated that the CRC screening-eligible population in the US is between 57.1 to 59.6 million in the US. CRC screening is generally provided in point-of-care settings where healthcare providers discuss and prescribe a CRC screening test for patients. However, a substantial portion of the screening-eligible population remains unscreened. One approach to increased CRC screening participation involves sending non-invasive test kits directly to screening-eligible individuals through a gap closure program as a bulk order. To date, the effectiveness of gap closure ordering has not been evaluated for the mt-sDNA test. This study assessed cross-sectional adherence to mt-sDNA test completion in a population of patients insured with Medicare Advantage plans who received a test kit through bulk order.

Methods: Individuals between 45 and 85 years of age, who were enrolled in a large Medicare Advantage insurance plan in the Southeastern region of the USA, were mailed a mt-sDNA test kit between March 1, 2023, and June 30, 2023. The primary outcome was patient adherence, defined as returned and valid test within 270 days from the initial shipment. Regression analysis was performed to determine available baseline characteristics that were associated with adherence.

Results: Of 3,201 individuals who were mailed a mt-sDNA test kit, overall adherence was 49.4% with an average of 25.5 days from initial shipment date to return of the valid test kit. The highest adherence was observed in the 65-75 age group (50.8%). Adherence rates in patient outreach with fully digital, partial digital with emails, and partial digital with text messages were 75.9%, 57.9%, and 51.1%, respectively; and significantly higher adherence than without digital outreach, 43.4% (p< 0.001). Regression analyses revealed that patients in the age group of 65-75 years, living in a small town, and receiving fully or partially digital patient outreach were independent predictors associated with increased adherence.

Discussion: Data from this large, commercial insurer-sponsored program shows that almost half of patients completed and returned their kit tests. The mt-sDNA mailed outreach program yielded an adherence rate 2 to 4 times higher than published mailed FIT adherence rates, supporting this approach as an effective and efficient strategy for improving CRC screening participation.


Disclosures:


Quang Le, PharmD, PhD¹, Mallik Greene, PhD², Timo Pew, MS², Alisdair R. Philp, PhD, MS³, Will K. Johnson, PhD, MSc¹, A. Burak Ozbay, MBA, PhD⁴, Michael Dore, MD⁵, A Mark Fendrick, MD⁶, Derek W. Ebner, MD⁷, John B. Kisiel, MD⁷, Paul Limburg, MD, MPH⁸. P0436 - Gap Closure Adherence to Multi-Targeted Stool DNA Test for Colorectal Cancer Screening in an Insured Cohort, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.