{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:33:10Z","timestamp":1772119990340,"version":"3.50.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Gastrointest Canc"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      Colorectal cancer remains a leading cause of cancer deaths, highlighting the need for early detection. Cologuard\n                      <jats:sup>\u00ae<\/jats:sup>\n                      , a non-invasive stool DNA test, detects biomarkers for CRC and precancerous lesions but requires follow-up colonoscopy and has a high false-positive rate. This study evaluates colonoscopy follow-up rates and diagnostic outcomes after positive Cologuard\n                      <jats:sup>\u00ae<\/jats:sup>\n                      results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the TriNetX database, a global federated real-world data platform, to analyze patients aged\u2009\u2265\u200918 years who tested positive on Cologuard. The primary outcome was whether patients underwent an endoscopic procedure (colonoscopy) within 12 months of a positive result. The secondary outcome was the diagnoses made during follow-up colonoscopy, including malignant neoplasms (colorectal cancer) and benign neoplasms (polyps).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 3,916 patients underwent Cologuard\n                      <jats:sup>\u00ae<\/jats:sup>\n                      testing, with 61.3% being female, 35% male, and 3.7% other genders. Of the 385 patients who tested positive for Cologuard\n                      <jats:sup>\u00ae<\/jats:sup>\n                      (mean age 65\u2009\u00b1\u20098.75 years), 171 (44%) underwent follow-up colonoscopy within 12 months. Of these, 10 cases (5.8%) were diagnosed with malignant neoplasms, and 56 cases (32.7%) were diagnosed with benign neoplasms (polyps).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The study found poor follow-up adherence, with only 44% completing colonoscopy and a high false positive rate with just 38.5% of positive Cologuard\n                      <jats:sup>\u00ae<\/jats:sup>\n                      results showing significant lesions. These findings emphasize the need for better patient education, streamlined care pathways, and improved communication to enhance follow-up compliance.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12029-025-01350-5","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T06:33:04Z","timestamp":1763447584000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["From Detection to Delay: Real-World Gaps in Post-Cologuard\u00ae Colonoscopy Adherence"],"prefix":"10.1007","volume":"56","author":[{"given":"Muhammad Ali Ibrahim","family":"Kazi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imran","family":"Qureshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akshay","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nirav","family":"Agrawal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahnoor","family":"Sarfraz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry","family":"Meisenberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanmeet","family":"Singh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"issue":"14","key":"1350_CR1","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1056\/NEJMoa1311194","volume":"370","author":"TF Imperiale","year":"2014","unstructured":"Imperiale TF, Ransohoff DF, Itzkowitz SH, Levin TR, Lavin P, Lidgard GP, et al. 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