{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T13:17:01Z","timestamp":1783603021567,"version":"3.55.0"},"reference-count":29,"publisher":"Harborside Press, LLC","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Fecal immunochemical tests (FITs), fecal occult blood tests (FOBTs), and multitarget stool DNA (mt-sDNA) tests are convenient, noninvasive colorectal cancer (CRC) screening strategies. However, delays in or failure to complete follow-up colonoscopy (FU-CY) after a positive noninvasive test are associated with higher CRC incidence, complications, and mortality. We sought to evaluate FU-CY rates, time to colonoscopy, and compliance predictors.\n                    <jats:bold>Patients and Methods:<\/jats:bold>\n                    This retrospective cohort study linked 2 data sources: Komodo Health Data with Exact Sciences Laboratories. Data were collected from January 2016 to June 2023 and analyzed in 2024. Study participants (ages 45\u201375 years) were individuals with positive stool-based CRC screening tests (FIT, guaiac-based FOBT, or mt-sDNA tests). FU-CY compliance was assessed at 30-day intervals up to 365 days, and logistic regression was used to identify predictors of FU-CY.\n                    <jats:bold>Results:<\/jats:bold>\n                    Among 362,646 participants, colonoscopy compliance was 77.1% for mt-sDNA and 45.1% for FIT\/FOBT (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;.001). Overall FU-CY compliance was lowest among Asian and Black populations, but was significantly higher in these subgroups for mt-sDNA versus FIT (Asian: 74.2% vs 41.1%; Black: 71.3% vs 44.6%). The strongest predictor of compliance was use of mt-sDNA (odds ratio, 3.98;\n                    <jats:italic>P<\/jats:italic>\n                    &lt;.001). More than half of participants across all race groups who completed FU-CY after mt-sDNA did so within the first 120 days, whereas none of the FIT\/FOBT racial subgroups reached 50% completion within 365 days.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Timely completion of colonoscopy after a noninvasive test is critical, as failure to undergo colonoscopy or delays in completion are associated with increased CRC incidence and more advanced-stage disease. These findings demonstrate that mt-sDNA use may help close CRC screening disparity gaps compared with FIT testing. FU-CY adherence is higher, and time to colonoscopy is shorter following a positive mt-sDNA test versus FIT across all racial and ethnic subgroups.\n                  <\/jats:p>","DOI":"10.6004\/jnccn.2026.7015","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T12:41:35Z","timestamp":1783600895000},"source":"Crossref","is-referenced-by-count":0,"title":["Multitarget Stool DNA Versus Fecal Immunochemical Testing: A National Assessment of Follow-Up Colonoscopy by Race and Ethnicity"],"prefix":"10.6004","volume":"24","author":[{"given":"Mallik","family":"Greene","sequence":"first","affiliation":[{"name":"Abbott, Madison, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Stieber","sequence":"additional","affiliation":[{"name":"Abbott, Madison, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Burak","family":"Ozbay","sequence":"additional","affiliation":[{"name":"Abbott, Madison, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Anderson","sequence":"additional","affiliation":[{"name":"Geisel School of Medicine at Dartmouth, Hanover, NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"LeMaster","sequence":"additional","affiliation":[{"name":"Kansas University Medical Center, Kansas City, KS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Dore","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Stukalin","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Arroyo","sequence":"additional","affiliation":[{"name":"AltaMed, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek W.","family":"Ebner","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Mark","family":"Fendrick","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Michigan, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan J.","family":"Karlitz","sequence":"additional","affiliation":[{"name":"Abbott, Madison, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"B1","series-title":"CA Cancer J Clin","first-page":"17","article-title":"Cancer statistics, 2023","volume":"73","author":"Siegel RL","year":"2023","unstructured":"Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin 2023;73:17\u201348."},{"key":"B2","series-title":"CA Cancer J Clin","first-page":"e70043","article-title":"Cancer statistics, 2026","volume":"76","author":"Siegel RL","year":"2026","unstructured":"Siegel RL, Kratzer TB, Wagle NS,  Cancer statistics, 2026. CA Cancer J Clin 2026;76:e70043."},{"key":"B3","article-title":"2023 cancer facts & figures","unstructured":"American Cancer Society. 2023 cancer facts & figures. Accessed March 21, 2025. Available at: https:\/\/www.cancer.org\/research\/cancer-facts-statistics\/all-cancer-facts-figures\/2023-cancer-facts-figures.html"},{"key":"B4","series-title":"JAMA","first-page":"1965","article-title":"Screening for colorectal cancer: US Preventive Services Task Force recommendation statement","volume":"325","author":"Davidson KW","year":"2021","unstructured":"Davidson KW, Barry MJ, Mangione CM,  Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA 2021;325:1965\u20131977."},{"key":"B5","series-title":"Int J Cancer","first-page":"1532","article-title":"Association between time to colonoscopy after a positive guaiac fecal test result and risk of colorectal cancer and advanced stage disease at diagnosis","volume":"146","author":"Beshara A","year":"2020","unstructured":"Beshara A, Ahoroni M, Comanester D,  Association between time to colonoscopy after a positive guaiac fecal test result and risk of colorectal cancer and advanced stage disease at diagnosis. Int J Cancer 2020;146:1532\u20131540."},{"key":"B6","series-title":"Cancer Epidemiol Biomarkers Prev","first-page":"344","article-title":"Time to colonoscopy after positive fecal blood test in four U.S. health care systems","volume":"25","author":"Chubak J","year":"2016","unstructured":"Chubak J, Garcia MP, Burnett-Hartman AN,  Time to colonoscopy after positive fecal blood test in four U.S. health care systems. Cancer Epidemiol Biomarkers Prev 2016;25:344\u2013350."},{"key":"B7","series-title":"JAMA","first-page":"1631","article-title":"Association between time to colonoscopy after a positive fecal test result and risk of colorectal cancer and cancer stage at diagnosis","volume":"317","author":"Corley DA","year":"2017","unstructured":"Corley DA, Jensen CD, Quinn VP,  Association between time to colonoscopy after a positive fecal test result and risk of colorectal cancer and cancer stage at diagnosis. JAMA 2017;317:1631\u20131641."},{"key":"B8","series-title":"Clin Gastroenterol Hepatol","first-page":"1344","article-title":"Association between time to colonoscopy after positive fecal testing and colorectal cancer outcomes: a systematic review","volume":"19","author":"Forbes N","year":"2021","unstructured":"Forbes N, Hilsden RJ, Martel M,  Association between time to colonoscopy after positive fecal testing and colorectal cancer outcomes: a systematic review. Clin Gastroenterol Hepatol 2021;19:1344\u20131354.e8."},{"key":"B9","series-title":"Clin Gastroenterol Hepatol","first-page":"1796","article-title":"Disparities in colorectal cancer screening in the United States before and after implementation of the Affordable Care Act","volume":"18","author":"May FP","year":"2020","unstructured":"May FP, Yang L, Corona E,  Disparities in colorectal cancer screening in the United States before and after implementation of the Affordable Care Act. Clin Gastroenterol Hepatol 2020;18:1796\u20131804.e2."},{"key":"B10","series-title":"Perspect Public Health","first-page":"105","article-title":"A systematic review of ethnic disparities in the uptake of colorectal cancer screening","volume":"143","author":"Sekhon Inderjit Singh HK","year":"2023","unstructured":"Sekhon Inderjit Singh HK, Lal N, Majeed A,  A systematic review of ethnic disparities in the uptake of colorectal cancer screening. Perspect Public Health 2023;143:105\u2013120."},{"key":"B11","series-title":"Gastroenterology","first-page":"354","article-title":"Causes of socioeconomic disparities in colorectal cancer and intervention framework and strategies","volume":"158","author":"Carethers JM","year":"2020","unstructured":"Carethers JM, Doubeni CA. Causes of socioeconomic disparities in colorectal cancer and intervention framework and strategies. Gastroenterology 2020;158:354\u2013367."},{"key":"B12","series-title":"Surg Oncol Clin N Am","first-page":"157","article-title":"Healthcare disparities and colorectal cancer","volume":"31","author":"Hollis RH","year":"2022","unstructured":"Hollis RH, Chu DI. Healthcare disparities and colorectal cancer. Surg Oncol Clin N Am 2022;31:157\u2013169."},{"key":"B13","series-title":"J Natl Cancer Inst","first-page":"dju032","article-title":"Challenges and possible solutions to colorectal cancer screening for the underserved","volume":"106","author":"Gupta S","year":"2014","unstructured":"Gupta S, Sussman DA, Doubeni CA,  Challenges and possible solutions to colorectal cancer screening for the underserved. J Natl Cancer Inst 2014;106:dju032."},{"key":"B14","series-title":"CA Cancer J Clin","first-page":"466","article-title":"Cancer statistics for the US Hispanic\/Latino population, 2021","volume":"71","author":"Miller KD","year":"2021","unstructured":"Miller KD, Ortiz AP, Pinheiro PS,  Cancer statistics for the US Hispanic\/Latino population, 2021. CA Cancer J Clin 2021;71:466\u2013487."},{"key":"B15","article-title":"NCQA advances development of a new HEDIS measure for colorectal cancer screening follow-up","unstructured":"National Committee for Quality Assurance. NCQA advances development of a new HEDIS measure for colorectal cancer screening follow-up. Accessed June 3, 2026. Available at: https:\/\/www.ncqa.org\/blog\/new-hedis-measure-for-colorectal-cancer-screening-follow-up"},{"key":"B16","series-title":"Clin Gastroenterol Hepatol","first-page":"1868","article-title":"Addressing gaps in colorectal cancer screening: the role of patient navigation and future directions","volume":"23","author":"Lieberman DA","year":"2025","unstructured":"Lieberman DA, Doubeni CA, Howard DE. Addressing gaps in colorectal cancer screening: the role of patient navigation and future directions. Clin Gastroenterol Hepatol 2025;23:1868\u20131874."},{"key":"B17","series-title":"J Natl Cancer Inst","first-page":"538","article-title":"Race and colorectal cancer disparities: health-care utilization vs different cancer susceptibilities","volume":"102","author":"Laiyemo AO","year":"2010","unstructured":"Laiyemo AO, Doubeni C, Pinsky PF,  Race and colorectal cancer disparities: health-care utilization vs different cancer susceptibilities. J Natl Cancer Inst 2010;102:538\u2013546."},{"key":"B18","series-title":"J Gen Intern Med","first-page":"1447","article-title":"Occurrence of distal colorectal neoplasia among Whites and Blacks following negative flexible sigmoidoscopy: an analysis of PLCO trial","volume":"30","author":"Laiyemo AO","year":"2015","unstructured":"Laiyemo AO, Doubeni C, Pinsky PF,  Occurrence of distal colorectal neoplasia among Whites and Blacks following negative flexible sigmoidoscopy: an analysis of PLCO trial. J Gen Intern Med 2015;30:1447\u20131453."},{"key":"B19","series-title":"Gastrointest Endosc Clin N Am","first-page":"413","article-title":"Colorectal cancer screening decisions in the opportunistic setting","volume":"30","author":"Han A","year":"2020","unstructured":"Han A, Maratt J, Kahi C. Colorectal cancer screening decisions in the opportunistic setting. Gastrointest Endosc Clin N Am 2020;30:413\u2013422."},{"key":"B20","series-title":"Gut","first-page":"561","article-title":"Non-compliance with colonoscopy after a positive faecal immunochemical test doubles the risk of dying from colorectal cancer","volume":"71","author":"Zorzi M","year":"2022","unstructured":"Zorzi M, Battagello J, Selby K,  Non-compliance with colonoscopy after a positive faecal immunochemical test doubles the risk of dying from colorectal cancer. Gut 2022;71:561\u2013567."},{"key":"B21","series-title":"JAMA Netw Open","first-page":"e241848","article-title":"Stage-stratified incidence rates of colorectal adenocarcinoma among patients aged 46 to 49 in the United States","volume":"7","author":"Montminy EM","year":"2024","unstructured":"Montminy EM, Zhou M, Edelson JC, Karlitz JJ. Stage-stratified incidence rates of colorectal adenocarcinoma among patients aged 46 to 49 in the United States. JAMA Netw Open 2024;7:e241848."},{"key":"B22","series-title":"Cancer Epidemiol Biomarkers Prev","first-page":"334","article-title":"Shifts in the proportion of distant stage early-onset colorectal adenocarcinoma in the United States","volume":"31","author":"Montminy EM","year":"2022","unstructured":"Montminy EM, Zhou M, Maniscalco L,  Shifts in the proportion of distant stage early-onset colorectal adenocarcinoma in the United States. Cancer Epidemiol Biomarkers Prev 2022;31:334\u2013341."},{"key":"B23","series-title":"Am J Gastroenterol","first-page":"375","article-title":"Inadequate utilization of diagnostic colonoscopy following abnormal FIT results in an integrated safety-net system","volume":"112","author":"Issaka RB","year":"2017","unstructured":"Issaka RB, Singh MH, Oshima SM,  Inadequate utilization of diagnostic colonoscopy following abnormal FIT results in an integrated safety-net system. Am J Gastroenterol 2017;112:375\u2013382."},{"key":"B24","series-title":"JAMA Netw Open","first-page":"e2251384","article-title":"Rates of follow-up colonoscopy after a positive stool-based screening test result for colorectal cancer among health care organizations in the US, 2017-2020","volume":"6","author":"Mohl JT","year":"2023","unstructured":"Mohl JT, Ciemins EL, Miller-Wilson LA,  Rates of follow-up colonoscopy after a positive stool-based screening test result for colorectal cancer among health care organizations in the US, 2017-2020. JAMA Netw Open 2023;6:e2251384."},{"key":"B25","series-title":"BMC Gastroenterol","first-page":"115","article-title":"Patients without colonoscopic follow-up after abnormal fecal immunochemical tests are often unaware of the abnormal result and report several barriers to colonoscopy","volume":"20","author":"Cusumano VT","year":"2020","unstructured":"Cusumano VT, Corona E, Partida D,  Patients without colonoscopic follow-up after abnormal fecal immunochemical tests are often unaware of the abnormal result and report several barriers to colonoscopy. BMC Gastroenterol 2020;20:115."},{"key":"B26","series-title":"Prev Sci","first-page":"124","article-title":"Implementing mailed colorectal cancer fecal screening tests in real-world primary care settings: promising implementation practices and opportunities for improvement","volume":"25","author":"Hohl SD","year":"2024","unstructured":"Hohl SD, Maxwell AE, Sharma KP,  Implementing mailed colorectal cancer fecal screening tests in real-world primary care settings: promising implementation practices and opportunities for improvement. Prev Sci 2024;25(Suppl 1):124\u2013135."},{"key":"B27","series-title":"Curr Med Res Opin","first-page":"1619","article-title":"Utilization of colorectal cancer screening modalities in the United States (2017\u20132023): a national multi-payer claims database analysis","volume":"41","author":"Greene M","year":"2025","unstructured":"Greene M, Gohil S, Stieber B,  Utilization of colorectal cancer screening modalities in the United States (2017\u20132023): a national multi-payer claims database analysis. Curr Med Res Opin 2025;41:1619\u20131628."},{"key":"B28","series-title":"Curr Med Res Opin","first-page":"983","article-title":"Adherence to colorectal cancer screening with multi-target stool DNA testing among first-time average-risk users in federally qualified health centers","volume":"41","author":"Greene M","year":"2025","unstructured":"Greene M, Pew T, Sakthisivabalan L,  Adherence to colorectal cancer screening with multi-target stool DNA testing among first-time average-risk users in federally qualified health centers. Curr Med Res Opin 2025;41:983\u2013993."},{"key":"B29","series-title":"JAMA Netw Open","first-page":"e242693","article-title":"Development of a follow-up measure to ensure complete screening for colorectal cancer","volume":"7","author":"Ciemins EL","year":"2024","unstructured":"Ciemins EL, Mohl JT, Moreno CA,  Development of a follow-up measure to ensure complete screening for colorectal cancer. JAMA Netw Open 2024;7:e242693."}],"container-title":["Journal of the National Comprehensive Cancer Network"],"original-title":[],"link":[{"URL":"https:\/\/jnccn.org\/view\/journals\/jnccn\/24\/7\/article-e267015.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jnccn.org\/downloadpdf\/journals\/jnccn\/24\/7\/article-e267015.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jnccn.org\/downloadpdf\/journals\/jnccn\/24\/7\/article-e267015.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T12:41:36Z","timestamp":1783600896000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnccn.org\/view\/journals\/jnccn\/24\/7\/article-e267015.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":29,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.6004\/jnccn.2026.7015","relation":{},"ISSN":["1540-1405","1540-1413"],"issn-type":[{"value":"1540-1405","type":"print"},{"value":"1540-1413","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}