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Low follow-up rates, especially among Black and Asian patients, after home colorectal cancer screening

Many patients who receive a positive stool-based screening test result for colorectal cancer did not follow this up with a colonoscopy within one year, according to a study of nearly 33,000 men and women aged 50 to 75 from 2017 to 2020. Stool-based screening tests are effective, noninvasive alternatives to colonoscopy, but to be effective they require a timely follow-up colonoscopy if the at-home test is positive.

In the study, follow-up colonoscopy rates were 43.3 percent after 90 days and 56.1 percent after one year. This rate is far off the follow-up target of 80% recommended by the U.S. Multi-Society Task Force on Colorectal Cancer and even the best performing health care organizations did not achieve this target. Although follow-up rates took a hit during the pandemic, the rate was only 56 percent within one year in pre-pandemic 2019.

Compared with White patients, follow-up rates were significantly lower among Black patients and Asian patients, but not Hispanic patients.

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