Quality improvement project reveals increased screening adherence using at-home stool DNA tests in eligible adults, highlighting persistent racial and language return disparities.
BACKGROUND: Colorectal cancer (CRC) is the second leading cause of cancer deaths in the US, with screening rates at 65% to 70%. This quality improvement project in a Southeast Minnesota health system (SMHS) aimed to enhance CRC screening using multitarget stool DNA (mt-sDNA) test kit delivery. METHODS: Of 13,561 eligible patients ages 45 to 75 years in the SMHS, 12,032 were offered home delivery of mt-sDNA kits through the electronic patient portal. RESULTS: Within 90 days, 1,953 kits (16.2%) were returned, with 158 (8.1%) showing abnormal results, leading to colonoscopy referrals. Communication channels included the electronic portal, postal mail messages, and phone calls. CONCLUSION: Implementing mt-sDNA screening resulted in a 4.13% adherence increase, compared with a 0.04% adherence increase without intervention. However, disparities in return rates revealed unexpected challenges in addressing racial and ethnic disparities, as White patients and native English speakers showed higher return rates.
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Strelow et al. (2025) studied this question.
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