S410 “I Was Screaming Hallelujah”: Patient and Provider Perceptions of Blood-Based Testing for Colorectal Cancer Screening

Résumé fourni par la source

Introduction: Blood-based tests for colorectal cancer (CRC) screening can offer advantages over stool-based tests such as FIT. Yet, we know little about patients’ and providers’ perceptions. We report findings from a mixed-methods study reporting patient adherence and patient and provider perceptions of blood-based testing for CRC screening. Methods: Patient participants were 45-75 and members of a large, integrated health system. Participants were mailed, but did not complete, a FIT through an organized FIT-screening program and were scheduled for a health-care encounter at any of nine clinical sites. Participants were randomized 1-to-1 to receive the offer of a blood-based test or usual care. Participants in the blood test conditions were consented and invited to complete a blood draw. We used purposive sampling to select and recruit patients (who did and did not complete the blood test) and providers/specialists who are involved in CRC screening. We administered telephone interviews using a semi-structured interview guide and recorded and transcribed interviews, then coded and analyzed content. Results: We initially randomized 2,026 patients; 1,927 were still eligible following post-randomization exclusions (1,003 to usual care and 924 to blood draw offer; mean age: 60, 62% female, 80% non-Hispanic White). Of the 924 allocated to the blood-draw group, 548 (59.3%) were reached via phone, of which 280 (51.1%) scheduled an appointment with the research team. Three-month CRC screening proportions were 19.4 percentage points higher in the blood-test group vs usual care (32.4% vs 13.0%; P value < 0.01). We interviewed 15 patients (11 completed and 4 did not complete the blood test) and 5 providers (3 primary care providers, 1 gastroenterologist (GI), and 1 GI medical assistant). Patients were enthusiastic about a blood test, citing the simplicity, ease, convenience, and high perceived accuracy of the test. Providers were also receptive to a blood-based test, if adequate performance could be achieved and if they have information that informs patients of the pros and cons of blood-based screening versus other screening tests. Conclusion: Patients who were offered a blood-based test for CRC were more than twice as likely to complete CRC screening as patients allocated to usual care. Patients and providers were willing and enthusiastic about blood-based CRC screening tests. Future research focusing on performance and communication is needed.

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