Beyond detection: Five-year screening behaviors and patient-reported perceptions in DETECT-A participants.

Abstract

10534 Background: Multi-cancer early detection (MCED) blood testing may improve early cancer detection. The impact of MCED testing on anxiety and standard of care (SoC) cancer screening adherence is not fully understood. Detecting cancers Earlier Through Elective mutation-based blood Collection and Testing (DETECT-A) enrolled 10,006 women aged 65 to 75 years from the Geisinger Health System (GHS) with no previous history of cancer and assessed a single instance of MCED (CancerSEEK) testing in 9,911 subjects. Herein , we report cancer survey results, and SoC screening adherence over a 5-year follow-up period (5YFU). Methods: Medical record review and participant surveys administered at prespecified intervals, including approximately 5 years after enrollment, were used to assess patient experience, anxiety, and commitment to SoC screening. Decision regret/participation was assessed using a 5-item, 5-point agreement scale; perceived impact on anxiety, depression, and intention to adhere to SoC screening were assessed using 3-option directional responses (more/less/no change), with a ‘prefer not to answer’ option. Observed SoC screening adherence was assessed through August 2024. SoC screening eligibility (U.S. Preventive Services Taskforce criteria) and adherence data were available for DETECT-A subjects. Changes in adherence over time were assessed using a mixed effects model. Results: 8,114 subjects completed all survey questions. 97.3% expressed no participation regret; 94.8% noted a willingness to participate again. Most participants reported no changes in anxiety (89.4%) or depression (96.6%) levels since enrollment. 98.7% reported an equal or greater likelihood of adhering to SoC screening. SoC screening adherence was assessed for a subset of DETECT-A subjects who had at least one month of active GHS patient status (Breast and CRC) and were also eligible for screening (Lung, Breast, CRC). DETECT-A subject SoC adherence was high at consent (Lung: 28.0%, Breast: 88.4%, CRC: 73.9%) and remained high at one year (Lung: 38.5%, CRC: 82.3%) or two-year (Breast: 87.7%) follow-up post consent. Adherence remained high throughout the follow-up period. Conclusions: DETECT-A subjects were satisfied with study participation and reported little change in anxiety and depression. Reported commitment to SoC screening adherence was high and observed adherence to recommended screening modalities was maintained over the follow-up period. In a controlled setting of a prospective clinical trial, MCED testing did not contribute to anxiety or depression and did not interfere with adherence to SoC screening.