P3169 - “I Was Screaming Hallelujah”: Patient and Provider Perceptions of Blood-Based Testing for Colorectal Cancer Screening

Cheryl A.. Johnson, MEd¹, Rajasekhara Mummadi, MD², Jennifer Schneider, MPH¹, Charisma Jenkins, ¹, Elizabeth Shuster, MS¹, David Amy, MA¹, Jennifer Cook, ¹, Samantha Sahnow, ¹, Jamilyn Zepp, ¹, Gloria Coronado, PhD^1
1Kaiser Permanente Center for Health Research, Portland, OR; ²Kaiser Permanente, Hillsboro, OR

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, one gastroenterologist (GI), and one 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.

Discussion: 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.


Disclosures:


Cheryl A.. Johnson, MEd¹, Rajasekhara Mummadi, MD², Jennifer Schneider, MPH¹, Charisma Jenkins, ¹, Elizabeth Shuster, MS¹, David Amy, MA¹, Jennifer Cook, ¹, Samantha Sahnow, ¹, Jamilyn Zepp, ¹, Gloria Coronado, PhD¹. P3169 - “I Was Screaming Hallelujah”: Patient and Provider Perceptions of Blood-Based Testing for Colorectal Cancer Screening, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.