Medicare beneficiaries may engage with a multi-target stool DNA test better than a fecal immunochemical test, according to a study debuted digitally at Digestive Disease Week 2020.
Researchers used the CRC-AIM model to see how a Medicare population would use a triennial multi-target stool DNA test, Cologuard, compared to annual FIT testing. The model uses natural history and colorectal cancer screening components that have been cross-validated against the Cancer Intervention and Surveillance Modeling Network models. Researchers tested an array of adherence models.
1. Both Cologuard and FIT added more life years gained than no screening at all.
2. At a 100 percent adherence rate between the ages of 50 and 75 years old, FIT added 5.8 percent more life years gained than Cologuard.
3. At a real-world rate of 70 percent adherence for Cologuard and 40 percent to 50 percent for FIT, Cologuard added between 8.3 percent and 18.7 percent more life years gained than FIT.
4. At equivalent adherence rates, Cologuard resulted in a higher number of total colonoscopies and a lower number of stool tests than FIT.
Researchers concluded: "Stool-based CRC screening provides higher LYG versus no screening, regardless of adherence assumptions. However, the comparative effectiveness of FIT versus mt-sDNA screening changes dramatically when adherence rates are assumed to be <100 percent, with mt-sDNA outperforming FIT under adherence assumptions that are more consistent with available, although currently incomplete, real-world evidence."