Colorectal cancer (CRC) screening is pivotal for early detection and improved outcomes, yet underserved populations face significant barriers to achieving screening goals. While colonoscopy remains the gold standard, non-invasive options such as the Fecal Immunochemical Test (FIT) annually and multitargeted stool DNA (mt-sDNA) every three years are increasingly viable, especially in underserved communities with decreased access to colonoscopies. Purpose This study evaluates the efficacy of FIT versus mt-sDNA in a Federally Qualified Health Center (FQHC) in Central California, focusing on return rates as a proxy for screening adherence. Methods A retrospective analysis was performed on over 1000 patients due for colorectal cancer screening between 2022-2023 and had a FIT or mt-sDNA test ordered individually during a visit, or via bulk order. We analyzed the return rates after at minimum 60 days from time of ordering CRC screening. Chi-square test of independence was utilized with multiple test correction via Bonferroni for p-values to demonstrate statistical significance between the different groups. Results FIT had a return rate of 25.8%, with 7% encountering collection or processing issues. In contrast, mt-sDNA ordered in bulk yielded a return rate of 13.2%, while mt-sDNA ordered individually by provider after a visit showed a higher return rate of 46.7%. Statistical analysis demonstrated significant differences in return rates between FIT and mt-sDNA under both ordering conditions (p < 0.05). Conclusion These findings suggest that mt-sDNA, valid for three years compared to FIT’s one-year validity, may enhance long-term adherence to CRC screening guidelines. The study underscores the impact of ordering strategy on screening effectiveness, particularly in FQHC settings. It highlights the potential of mt-sDNA, especially when ordered during a visit, to improve CRC screening rates compared to FIT.
Cheng et al. (Tue,) studied this question.