Fewer than half of patients followed up with a colonoscopy after abnormal blood-based colorectal cancer screening.
A new study from UCLA Health reveals that while blood-based tests for colorectal cancer offer a more convenient screening option, many patients do not complete the critical follow-up colonoscopy needed to confirm abnormal results.
The research, led by investigators at the UCLA Health Jonsson Comprehensive Cancer Center, found that only 49% of patients who received an abnormal blood-based screening result completed a colonoscopy within six months. Over the two-year study period, just 56% of patients ever completed the follow-up procedure.
“Blood-based colorectal cancer screening is promising, but it only works if individuals complete the follow-up colonoscopy,” said Folasade May, MD, PhD, MPhil, associate professor of medicine at the David Geffen School of Medicine at UCLA and senior author of the study. “More efforts are needed to help patients follow through to actually diagnose and treat the disease.”
Follow-Up Gaps Mirror Stool-Based Screening Rates
According to the study, the follow-up rates for blood-based tests were comparable to those observed for stool-based screenings but remain far below the levels considered optimal for timely detection and treatment of colorectal cancer. Colonoscopy is a crucial next step after an abnormal screening result, allowing physicians to confirm the presence of cancer or pre-cancerous polyps.
The study also highlighted disparities related to insurance type and overall health. Patients with Medicare Advantage were significantly less likely to complete a follow-up colonoscopy compared to those with private insurance. Additionally, individuals with fewer health conditions were more likely to pursue timely follow-up care. Race and ethnicity were not significant predictors of follow-up completion in this cohort, in contrast to prior research on stool-based screening.
Colorectal Cancer Screening Remains a Vital Public Health Priority
Colorectal cancer is the second leading cause of cancer-related deaths in the United States among men and women combined. Experts emphasize that early detection through regular screening can save lives. However, many patients avoid screening due to fear, limited access, or challenges with preparation for traditional tests such as colonoscopy or stool-based screening.
Folasade May, MD, PhD, MPhil, associate professor of medicine at the David Geffen School of Medicine at UCLA said, “This study underscores that convenience alone does not ensure early cancer detection. Patients, clinicians, and health systems must work together to ensure that abnormal results lead to timely diagnostic procedures.”
Study Design and Methodology
The researchers conducted a retrospective analysis of medical claims data from more than 6,000 individuals aged 45 and older who received the Shield blood-based colorectal cancer screening test between 2022 and 2024. The analysis focused on 452 patients who received an abnormal result and tracked whether they completed a follow-up colonoscopy within six months.
Timothy Zaki, MD, a senior gastroenterology fellow at UCLA Health and the study’s first author, said the findings provide valuable real-world insight into patient behavior after blood-based screenings. “Understanding how often patients follow through with colonoscopy after an abnormal result is critical to assessing the potential impact of these newer screening methods on colorectal cancer outcomes,” he said.
Implications for Clinical Practice
The study, published in the journal Gastroenterology, emphasizes that timely follow-up is essential to ensure that blood-based screening tests translate into meaningful health benefits. Delays or failures to undergo colonoscopy after an abnormal result can compromise early detection and treatment, reducing the overall effectiveness of screening programs.
May added, “Our findings highlight the need for targeted interventions to improve follow-up rates, particularly among patients with Medicare Advantage or multiple health conditions. These steps are crucial to fully realize the potential of blood-based colorectal cancer screening.”
Growth of the middleman company is a sign of increased credibility and acceptance among its client organizations
There’s a new category of player in the clinical laboratory testing industry. It is the “middleman” company. One high-profile example of a middleman company in diagnostics is the company ixlayer of San Francisco, which has a novel plan for growth.
The software developer provides cloud-based diagnostic testing platforms to retailers, health plans, and biopharma companies. Medical laboratory tests are not processed by ixlayer, however, but are instead sent to independent CLIA-certified clinical labs for completion and results reporting.
Thus, ixlayer acts as a third-party “middleman” in the lab testing chain.
Ixlayer recently debuted as number 1,418 on the 2023 Inc. 5000 list of fastest-growing private companies in the US, according to a company news release. Might this signal a dynamic and expanding clinical laboratory middleman sector?
There are a number of other established middleman companies doing this on the web as well, including:
Produced by Inc. Business Media, the Inc. 5000 list is based on data analysis of the fastest growing private businesses in the US. Ixlayer reportedly grew its 2023 revenue 100% year-over-year.
“To be selected for the Inc. 5000 list is an honor that validates the value we deliver while enabling greater access to care for all,” said Pouria Sanae (above), co-founder and CEO of ixlayer. “We’ve developed a platform that powers millions of diagnostic tests each year and serves as the backbone of thousands of health testing programs for trusted health brands, healthcare delivery organizations, payers, and life sciences companies. I’m excited about the future as we redefine and simplify the diagnostic laboratory testing ecosystem.” (Photo copyright: ixlayer.)
Ixlayer Works with Retailers, Insurers, Biopharma, and Clinical Labs
Ixlayer “facilitates” tests by working with industry partners and clinical laboratories, Managed Healthcare Executive explained.
One such relationship is with retailer CVS, Fierce Healthcare reported. Ixlayer provides the cloud-based diagnostics platform, at-home sample collection kits, and coordination of testing services for some of the pharmacy company’s at-home testing products. They include:
“With nearly 70% of medical decisions dependent on lab testing, regular diagnostic testing is a cornerstone of improving health and wellness,” Pouria Sanae, co-founder and CEO of ixlayer, told Drug Store News. “At-home testing enables people to proactively take control of their health, on their own schedule, in the privacy of their own home and on a regular basis. Our mission of creating a healthier world through more accessible, affordable, and easy health testing requires systemic changes and buy-in from key stakeholders and partners.”
Ixlayer directs specimens to independent labs that perform the tests and report results to consumers via an online portal.
“Founded in 2018, ixlayer initially focused on remote lab testing for Alzheimer’s disease patients. The company now offers thousands of white-labeled, at-home, and onsite health tests ranging from women’s wellness to sexually transmitted diseases and chronic condition management,” the news release notes.
“We’re thinking of it more from the perspective of: How do we infiltrate this infrastructure into our whole healthcare ecosystem? How do we let traditional providers run their programs the way they want to?” Alecia Pritchett, ixlayer Chief Growth Officer, told Managed Healthcare Executive.
Ixlayer “is not a lab,” Managed Healthcare Executive explained. “It describes itself as a platform. Instead of performing its own lab tests, it connects providers and retailers to accredited laboratory partners. Instead of sending out its own team of phlebotomists to collect blood samples, the company coordinates with mobile phlebotomy firms.”
“This comprehensive data visualization solution provides a more insightful analysis of testing performance data, empowering health plans, retailers, and biopharma organizations to monitor and manage progress in real-time effectively. With this actionable intelligence, decision-makers can focus on addressing gaps in care, accelerating access to critical drug studies, and promoting greater health equity to improve clinical and quality outcomes and economics across the healthcare ecosystem,” said David Yu, Chief Product Officer at ixlayer, in a news release.
Any Lab Test Now Also Makes Inc.’s 5000 List
Also making the 2023 Inc. 5000 list is Any Lab Test Now, an Alpharetta, Ga.-headquartered laboratory franchise that was founded in 2007. Any Lab Test Now is another form of middleman company which bills itself as the nation’s first direct access lab testing service with 200 locations. This is Any Lab Test Now’s second consecutive year on the list, according to a news release.
Unlike ixlayer, Any Lab Test Now’s business model features independently owned and operated locations around the US. Customers go online to choose a testing location, pay for tests, and schedule an appointment. Tests include:
Allied Market Research reported that the global at-home testing market is expected to grow by about 10.5% annually from 2022 to 2031, when it will reach $45.5 billion.
Another middleman company offering at-home tests is Everlywell of Austin, Texas. Other middleman companies that enable consumers to order tests online and then visit a local clinical laboratory for specimen collection include Testing.com and Walk-In-Lab.com.
Ever since the COVID-19 pandemic, demand for at-home sample collection testing has grown steadily. Dark Daily has covered this in numerous ebriefs. That middleman companies are showing up on the Inc. 5000 list of fastest growing companies indicates that the middleman sector of the clinical laboratory testing industry is growing as well.
