(HealthDay News) — Among an average-risk population, follow-up colonoscopy rates are low after a positive noninvasive stool-based screening test for colorectal cancer, according to a study published in JAMA Network Open.

For this study, researchers conducted interviews with clinicians from 5 health care organizations and analyzed deidentified administrative claims and electronic health records data between June 1, 2015, and June 30, 2021. The data encompassed 32,769 patients (mean age, 63.1 years).

The follow-up colonoscopy rate was 43.3% within 90 days of a positive stool-based screening test result, 51.4% within 180 days, and 56.1% within 360 days. When interviewed, clinicians were uniformly surprised by the low follow-up colonoscopy rates.

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Follow-up colonoscopy rates varied by race, ethnicity, insurance type, presence of comorbidities, and type of stool-based screening test used. The strongest positive association was seen with multitarget stool DNA use (hazard ratio, 1.63 relative to fecal immunochemical tests), and the strongest negative association was seen with the presence of comorbidities (hazard ratio, 0.64 for a Charlson Comorbidity Index >4 vs 0).

“At-home stool-based testing offers a useful tool to supplement routine colonoscopy and reach a wider patient population,” the study authors wrote. “Nonetheless, it is important to emphasize that all positive SBTs [stool-based screening tests] must be followed by a timely colonoscopy to complete the screening paradigm.”

The study was funded by the Exact Sciences Corporation.

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