University of Pittsburgh Medical Center Ann Arbor, MI
Linda Jiang, MD, Robert Schoen, MD, MS University of Pittsburgh Medical Center, Pittsburgh, PA
Introduction: Multi-target stool DNA (mt-sDNA) testing is a widely used screening test for colorectal cancer. Few studies have evaluated the performance of mt-sDNA testing in clinical practice. To our knowledge, no study has characterized the utility in completing screening using repeated orders of mt-sDNA testing for the same patient. This study aims to evaluate the completion rates of patients who received repeat orders for mt-sDNA testing.
Methods: We assessed mt-sDNA testing at the University of Pittsburgh Medical Center from January 1st, 2017 to December 31st, 2021. Data collection included electronic medical record capture of mt-sDNA orders, test completions and results, supplemented by manual chart review. Orders were grouped into 120-day ordering periods.
Results: A total of 91,664 mt-sDNA orders were prescribed for 73,704 patients. The overall completion rate was 54.7% (40,337/73,704) [Table 1]. Patients received up to 7 orders.
Of patients who received 1 order, 33,965/59,322 (57.3%) completed testing; of patients who received 2 orders, 5520/11,494 (48.0%); for 3 orders, 744/2,322 (32.0%); for 4 orders, 98/463 (21.2%); for 5 orders, 10/83 (12.0%); and for 6 or 7 orders, 0/20 (0.0%). In a logistic regression model, the number of repeat orders was inversely associated with test compliance. Compared to patients who received 1 order, the odds of test completion were 0.69 (95% CI [0.66, 0.72]) for 2 orders, 0.35 (95% CI [0.32, 0.38]) for 3 orders, 0.20 (95% CI [0.16, 0.25]) for 4 orders, and 0.10 (95% CI [0.05, 0.19]) for 5 orders [Table 1].
Discussion: Completion of mt-sDNA testing declines significantly with successive orders. The completion rate is only 32% for patients with 3 orders and 20% after 4 orders. Repeated mt-sDNA orders are not an efficient means of accomplishing colorectal cancer screening.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Linda Jiang indicated no relevant financial relationships.
Linda Jiang, MD, Robert Schoen, MD, MS. P2155 - Success of Repeated Orders for Multi-target Stool DNA Testing in Clinical Practice, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
