Stool DNA-based versus colonoscopy-based colorectal cancer screening: Patient perceptions and preferences

Abstract

Objective: Stool DNA (sDNA) tests offer a noninvasive form of colon cancer screening for patients, and although the test is expected to increase uptake of colon cancer screening, it is unknown if patients' perceptions of the sDNA test differ according to race and other patient characteristics. Methods: We conducted a self-administered survey of patients undergoing both a colonoscopy and an sDNA test to evaluate perceptions of sDNA testing. Results: Of the 613 participants who were sent surveys, 423 responded (69% response rate). Respondents self-identified as African American (n=127, 30%), Caucasian (n=284, 67%), and other ethnicity (n=12, 3%). In general, participants found the sDNA test more suitable than a colonoscopy (n=309, 75%). In univariate analyses, a higher percentage of Caucasians as compared with African Americans found the sDNA test more suitable than a colonoscopy (89% vs. 76%, p<0.01), and more Caucasians than African Americans preferred the sDNA test (43% vs. 32%, p<0.05). Adjustment for covariates reduced these racial differences to no significance. A family history of colorectal cancer remains a significant factor for patient's preferences for screening regardless of race. Conclusions: Our study shows no racial differences in the perception of and preference for sDNA testing for colon screening. Intervention to increase the uptake of sDNA testing may help reduce racial disparities in colorectal cancer.