Evaluation of a Tailored Patient Navigation Program for Improving Multitarget Stool DNA Test Adherence

Background: Multitarget stool DNA (mt-sDNA) is an increasingly utilized noninvasive option for colorectal cancer screening; however, its impact is limited by imperfect test adherence. Tailored patient navigation (TPN) improves adherence for other cancer screening tests, but its role in mt-sDNA is not known. Aim: Determine whether TPN improves mt-sDNA completion and reduces sample could not be processed (SCNBP) result rates. Setting: A large, urban, academic primary care clinic serving a medically vulnerable population. Participants: All patients who received mt-sDNA order in 2022 and 2023. Program Description: A patient navigator outreached all patients ordered mt-sDNA to support test completion during the 12-month intervention period in 2023. Program Evaluation: Rates of mt-sDNA completion within 90 days and SCNBP results were compared between the 12-month intervention and pre-intervention periods using generalized estimating equations. A total of 2694 patients received 3297 orders during the study. TPN was significantly associated with improved rates of 90-day mt-sDNA completion (51% vs. 39%, OR 1.67, p <.001) and SCNBP results (4% vs. 5%, OR 0.55, p <.001). Discussion: Tailored patient navigation was associated with improved rates of mt-sDNA completion and SCNBP results despite built-in navigation services provided by the manufacturer. TPN for mt-sDNA is a promising strategy for enhancing colorectal cancer screening uptake.