Primary care physicians order most Cologuard tests; 71% of Medicare population completes test within a year

The majority of Medicare patients were likely to complete the multitarget stool DNA test Cologuard over a yearlong period, according to a study published in the Journal of Medical Screening.

Researchers studied how a Medicare population of adults completed Cologuard over a yearlong test period. Researchers examined 386,494 Medicare beneficiaries between ages 65 and 85 years between Sept. 1, 2016, and Aug. 31, 2017.

Once receiving a valid test order, patients were supported by a patient navigation system that included phone calls, mailed reminders and a continuously available call center. Patients received up to two phone call reminders and a mailed reminder approximately 30 days after the physician made the test order. Reminders were discontinued after receiving the final reminder or a completed test order.

What you should know:

1. Overall cross-sectional adherence — the amount of people completing the test within 365 days — was 71 percent.

2. Primary care physicians far outnumbered any type of specialist ordering the test, representing 325,394 orders or 88 percent of the order base. Gastroenterologists ordered 22,210 tests or 6 percent of the order base. However, tests ordered by gastroenterologists had higher adherence rates (78 percent) than those ordered by PCPs (70.7 percent) or other specialists.

3. Patients in states with both high and low levels of colorectal cancer screening rates both demonstrated high levels of adherence after ordering Cologuard.

4. Median time to adherence was 27 days.

Researchers concluded: "High initial CRC screening adherence rates can be achieved with mt-sDNA testing. Features of the mt-sDNA test such as the noninvasive approach, widespread accessibility, and embedded patient navigation system probably contributed to successful test completion, and can be further leveraged to accelerate realization of CRC screening participation targets," but noted several limitations available here.

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