Low follow-up endoscopy rate after positive stool-based test

Low follow-up endoscopy rate after positive stool-based test

According to a study published online on January 18, Open JAMA network.

Dr. Jeff T. Mohl from the American Medical Corporation Association in Alexandria, Virginia and colleagues conducted a multi-method study that included a retrospective analysis of identified administrative complaints and electronic health record data from June 1, 2015 to June 30, 2021, as well as interviews with clinicians from five healthcare institutions to assess rates of FU- CY after having a positive SBT result. The rote included 32,769 individuals (mean age, 63.1 years).

The researchers found that the FU-CY rates were 43.3, 51.4, and 56.1%, respectively, within 90, 180, and 360 days of a positive SBT result. When interviewed, clinicians were surprised by the low FU-CY ratio. There were observed differences in rates by race, ethnicity, coverage type, presence of comorbidities, and type of SBT used. The strongest positive association was seen with the use of multitarget fecal DNA (hazard ratio, 1.63 vs fecal immunohistochemistry) and the strongest negative association was seen with presence of comorbidities (hazard ratio, 0.64 for the Charlson Comorbidities Index >4 vs. 0).

“Home stool-based testing provides a useful tool to complement conventional colonoscopy and reach more patients,” the authors write. “However, it is important to emphasize that all positive SBTs must be followed up with timely endoscopy to complete the screening model.”

The study was funded by the Exact Science Corporation.

More information:
Jeff T. Mohl et al., Colonoscopy follow-up rates after positive stool-based screening test results for colorectal cancer among healthcare institutions in the United States, 2017- 2020, Open JAMA network (2023). DOI: 10.1001/jamanetworkopen.2022.51384

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