Real-World Adherence to Multi-Target Stool DNA Testing for Colorectal Cancer Among Asian Americans

Introduction: Asian Americans have lower colorectal cancer (CRC) screening rates compared to other racial/ethnic groups. Given the importance of early detection and subsequent treatment in improving survival, this study examines adherence to first-time multitarget stool DNA (mt-sDNA) testing among A...

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Main Authors: Mallik Greene PhD, DBA, Mark Camardo MS, Quang A. Le PharmD, PhD, Raja Kakuturu PhD, A. Burak Ozbay PhD, MBA, A. Mark Fendrick MD, Michael Dore MD, Paul Limburg MD
Format: Article
Language:English
Published: SAGE Publishing 2025-03-01
Series:Cancer Control
Online Access:https://doi.org/10.1177/10732748251330695
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author Mallik Greene PhD, DBA
Mark Camardo MS
Quang A. Le PharmD, PhD
Raja Kakuturu PhD
A. Burak Ozbay PhD, MBA
A. Mark Fendrick MD
Michael Dore MD
Paul Limburg MD
author_facet Mallik Greene PhD, DBA
Mark Camardo MS
Quang A. Le PharmD, PhD
Raja Kakuturu PhD
A. Burak Ozbay PhD, MBA
A. Mark Fendrick MD
Michael Dore MD
Paul Limburg MD
author_sort Mallik Greene PhD, DBA
collection DOAJ
description Introduction: Asian Americans have lower colorectal cancer (CRC) screening rates compared to other racial/ethnic groups. Given the importance of early detection and subsequent treatment in improving survival, this study examines adherence to first-time multitarget stool DNA (mt-sDNA) testing among Asian American patients. Methods: This retrospective study linked two data sources: Komodo Research Data + MapEnhance Komodo Lab database and the Exact Sciences Laboratories database. Asian American’s 45 years and older who were first-time users of mt-sDNA testing between 2017 and 2023, with continuous insurance enrollment for two years, were included. Adherence to mt-sDNA testing was analyzed using descriptive statistics and logistic regression to identify factors associated with adherence. Results: The final sample included 336 288 Asian American patients, primarily covered by commercial insurance (70.3%), aged 50-75 years (80.7%), female (56.5%), living in metropolitan areas (95.4%), and under the care of a primary care physician (74.9%). Overall adherence to mt-sDNA testing was 70.9%, with significant variation by payer type ranging from 60.7% for Medicaid to 72.2% for Medicare ( P < 0.0001). Overall adherence rates were approximately 70% across all age groups, sexes, and geographic regions but were notably high among gastroenterology (GI) provider patients (81.6%) and those receiving full digital outreach (via both SMS and email) (72.8%). Logistic regression identified several significant predictors of adherence: older age, males, coverage by commercial insurance, residing outside metropolitan areas, seeing GI providers, receiving digital outreach via SMS or both SMS and email, and preferring English. Conclusion: This study found that Asian American patients that were first-time users of mt-sDNA testing had high adherence rates. However, significant disparities existed within this population based on payer type and sociodemographic factors. Targeted outreach strategies are essential to reduce barriers and improve CRC screening uptake, ultimately reducing the burden of CRC in the Asian American population.
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spelling doaj-art-5ab4392e2dac4f77aa21b0c83096759b2025-08-20T02:25:58ZengSAGE PublishingCancer Control1526-23592025-03-013210.1177/10732748251330695Real-World Adherence to Multi-Target Stool DNA Testing for Colorectal Cancer Among Asian AmericansMallik Greene PhD, DBAMark Camardo MSQuang A. Le PharmD, PhDRaja Kakuturu PhDA. Burak Ozbay PhD, MBAA. Mark Fendrick MDMichael Dore MDPaul Limburg MDIntroduction: Asian Americans have lower colorectal cancer (CRC) screening rates compared to other racial/ethnic groups. Given the importance of early detection and subsequent treatment in improving survival, this study examines adherence to first-time multitarget stool DNA (mt-sDNA) testing among Asian American patients. Methods: This retrospective study linked two data sources: Komodo Research Data + MapEnhance Komodo Lab database and the Exact Sciences Laboratories database. Asian American’s 45 years and older who were first-time users of mt-sDNA testing between 2017 and 2023, with continuous insurance enrollment for two years, were included. Adherence to mt-sDNA testing was analyzed using descriptive statistics and logistic regression to identify factors associated with adherence. Results: The final sample included 336 288 Asian American patients, primarily covered by commercial insurance (70.3%), aged 50-75 years (80.7%), female (56.5%), living in metropolitan areas (95.4%), and under the care of a primary care physician (74.9%). Overall adherence to mt-sDNA testing was 70.9%, with significant variation by payer type ranging from 60.7% for Medicaid to 72.2% for Medicare ( P < 0.0001). Overall adherence rates were approximately 70% across all age groups, sexes, and geographic regions but were notably high among gastroenterology (GI) provider patients (81.6%) and those receiving full digital outreach (via both SMS and email) (72.8%). Logistic regression identified several significant predictors of adherence: older age, males, coverage by commercial insurance, residing outside metropolitan areas, seeing GI providers, receiving digital outreach via SMS or both SMS and email, and preferring English. Conclusion: This study found that Asian American patients that were first-time users of mt-sDNA testing had high adherence rates. However, significant disparities existed within this population based on payer type and sociodemographic factors. Targeted outreach strategies are essential to reduce barriers and improve CRC screening uptake, ultimately reducing the burden of CRC in the Asian American population.https://doi.org/10.1177/10732748251330695
spellingShingle Mallik Greene PhD, DBA
Mark Camardo MS
Quang A. Le PharmD, PhD
Raja Kakuturu PhD
A. Burak Ozbay PhD, MBA
A. Mark Fendrick MD
Michael Dore MD
Paul Limburg MD
Real-World Adherence to Multi-Target Stool DNA Testing for Colorectal Cancer Among Asian Americans
Cancer Control
title Real-World Adherence to Multi-Target Stool DNA Testing for Colorectal Cancer Among Asian Americans
title_full Real-World Adherence to Multi-Target Stool DNA Testing for Colorectal Cancer Among Asian Americans
title_fullStr Real-World Adherence to Multi-Target Stool DNA Testing for Colorectal Cancer Among Asian Americans
title_full_unstemmed Real-World Adherence to Multi-Target Stool DNA Testing for Colorectal Cancer Among Asian Americans
title_short Real-World Adherence to Multi-Target Stool DNA Testing for Colorectal Cancer Among Asian Americans
title_sort real world adherence to multi target stool dna testing for colorectal cancer among asian americans
url https://doi.org/10.1177/10732748251330695
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