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Many Patients Prefer Stool-Based Colorectal Cancer Screening Tests

TUESDAY, May 4, 2021 -- Many patients prefer stool-based colorectal cancer screening tests over colonoscopy, according to a study published in the May issue of Cancer Prevention Research.

Xuan Zhu, Ph.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues examined patient preference in a panel survey focusing on colorectal cancer screening options (fecal immunochemical test or guaiac-based fecal occult blood test [FIT/gFOBT], multitarget stool DNA [mt-sDNA] test, and colonoscopy) among U.S. adults aged 40 to 75 years at average colorectal cancer risk. Overall, 31.3 percent (1,595 individuals) of those invited to participate completed the survey.

The researchers found that more respondents preferred mt-sDNA (65.4 percent) over colonoscopy; FIT/gFOBT (61 percent) over colonoscopy; and mt-sDNA (66.9 percent) over FIT/gFOBT when presented with a choice between two screening modalities. Preferences were influenced by certain demographic characteristics and awareness of and/or experience with various screening modalities. For example, uninsured people were more likely to prefer stool-based screening over colonoscopy (odds ratios, 2.53 and 2.73 for mt-sDNA and FIT/gFOBT, respectively); those who had heard of stool-based screening were more likely to prefer mt-sDNA over FIT/gFOBT (odds ratio, 2.07); and those who previously had a stool-based test were more likely to prefer FIT/gFOBT over colonoscopy (odds ratio, 2.75). The likelihood of preferring mt-sDNA or FIT/gFOBT over colonoscopy was lower for those who previously had a colonoscopy (odds ratios, 0.39 and 0.40, respectively).

"These findings underscore the importance of continuing to offer colorectal cancer screening options to patients and encourage health care providers to engage patients in shared decision making," the authors write.

Several authors disclosed financial ties to Exact Sciences, which funded the study.

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