American Association for Cancer Research — Cancer Prevention Research — 22 April 2021
A new nationally representative study published in Cancer Prevention Research found that when given a choice, most individuals with an average risk of colorectal cancer said they would prefer a stool-based screening test over colonoscopy. Of 1,062 respondents aged 45 to 75 with average risk, 66% said they preferred the multi-target stool DNA test (mt-sDNA) over colonoscopy, and 61% preferred the annual fecal immunochemical test (FIT/FOBT) over colonoscopy. Despite these preferences, colonoscopy remains the method most often recommended by health care providers.
Colorectal cancer is the second most frequent cause of cancer-related death in the United States, yet about one-third of eligible adults have never completed a screening test. The preference for stool-based testing was higher among younger adults (ages 45 to 54) compared to older adults (ages 65 to 75). Respondents without insurance were 2.5 times more likely to prefer the less expensive stool-based tests, and overall awareness of stool-based tests (about 60%) was significantly lower than for colonoscopy (about 90%).
Lead author Dr. Xuan Zhu said: “The best colorectal cancer screening test is the one that patients are most likely to complete.” The findings highlight the importance of patient education about available screening options and incorporating patients’ needs and values into shared decision-making discussions, in order to increase colorectal cancer screening rates. The US Preventive Services Task Force recommends beginning average-risk screening at age 45.