P3672 - Real-World Adherence to Repeat Testing for Stool-Based Non-Invasive Colorectal Cancer Screening Tests Among Individuals With Average Risk

Award: Presidential Poster Award

Aasma Shaukat, MD, MPH¹, Jiemin Liao, MA², Jayati Saha, MS, PhD, MPH², Shaun P. Forbes, PhD², Angela Watkins, MBA, MPH³, Nicole J.. Zhang, MPH², Victoria M.. Raymond, MS⁴, Amarendra Das, MD, PhD², Craig Eagle, MD², AmirAli Talasaz, PhD^2
1NYU Langone Health, New York, NY; ²Guardant Health, Palo Alto, CA; ³Guardant Health, Redwood City, CA; ⁴Guardant Health, San Diego, CA

Introduction: Stool-based tests such as the fecal immunochemical test (FIT) and multi-target stool DNA test (mt-sDNA) are non-invasive options used in average risk CRC screening. The benefit of these tests accrues through repeat testing at regular intervals (1-3 years) and the participant adherence to repeat testing is important to realizing these clinical outcomes. Therefore, we sought to assess repeat testing patterns of FIT and mt-sDNA and to evaluate predictors of repeat adherence.

Methods: Patients were identified from the Truveta database, which consists of deidentified medical records from 30 health systems, covering 107 million individuals in the US. Patients aged 45-75 years who received at least one FIT or mt-sDNA test between 1/2017 and 12/2019 were included, with study end date of 12/2023. Index date was defined as the first test order date, with a baseline period of one year prior to index and 4 years of follow-up post index. Patients who had colonoscopies during baseline were excluded. Screening colonoscopies were included as a testing modality if they occurred during the follow-up period. Univariate and multivariable logistic regression models were used to assess associations between repeat testing adherence and patient characteristics.

Results: 372,522 eligible patients were identified. Most patients (52%) only received one FIT or mt-sDNA test over their four-year follow-up time. Among patients whose first observed test was FIT, 49% had 2+ tests, but only 11% had 4+ tests. Among patients whose first test was mt-sDNA, 45% had 2+ tests. Factors associated with repeat testing adherence (defined as 2+ tests during the entire study period), were male sex, married status, and non-Hispanic ethnicity. Compared to Whites, adherence was higher in Asians, while Black and Native American individuals were less likely to adhere to repeat testing. As compared to those age 50-64, repeat testing adherence was higher in those 65+ and lower in those less than 50 (Table 1).

Discussion: Our results found that less than half of patients who underwent stool-based CRC screening received more than one test in a four-year period, highlighting the need for interventions to improve adherence to repeat testing adherence, especially in women, Black and Native American individuals, and unmarried individuals. The strongest predictors of repeat testing adherence were region and provider specialty, suggesting that better healthcare institutional policies are needed to shape future CRC screening strategies.


Disclosures:


Aasma Shaukat, MD, MPH¹, Jiemin Liao, MA², Jayati Saha, MS, PhD, MPH², Shaun P. Forbes, PhD², Angela Watkins, MBA, MPH³, Nicole J.. Zhang, MPH², Victoria M.. Raymond, MS⁴, Amarendra Das, MD, PhD², Craig Eagle, MD², AmirAli Talasaz, PhD². P3672 - Real-World Adherence to Repeat Testing for Stool-Based Non-Invasive Colorectal Cancer Screening Tests Among Individuals With Average Risk, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.