Table 3.
Barriers to MSI/IHC ordering stratified by those routinely and non-routinely ordering testing on colonoscopy biopsy specimens
| Barrier to MSI/IHC test ordering | Non-routinely orderinga | Routinely orderinga | Odds ratio (95% CI) |
|---|---|---|---|
| Cost of MSI and/or IHC testing is prohibitive | 33.3% | 11.7% | 3.79 (2.19, 6.53) |
| Lack of familiarity interpreting and applying the results from MSI and/or IHC testing | 29.2% | 6.2% | 6.23 (3.15, 12.35) |
| Lack of access to genetic counseling at my facility | 24.9% | 5.6% | 5.56 (2.72, 11.39) |
| Lack of access to germline genetic testing if MSI/IHC abnormal | 20.0% | 6.2% | 3.82 (1.89, 7.72) |
| Waiting for germline testing results (after initial MSI and/or IHC testing) would delay resection and therefore negatively impact the patient’s outcome | 18.2% | 5.7% | 3.72 (1.78, 7.77) |
| Waiting for MSI and/or IHC testing results would delay colon resection and therefore negatively impact the patient’s outcome | 14.1% | 4.5% | 3.50 (1.54, 7.92) |
| Ordering testing may adversely affect a patient’s medical insurance status | 12.0% | 6.2% | 2.08 (0.98, 4.40) |
aThe definition of routinely vs. non-routinely ordering is based on the survey question of “What percentage of the time will you plan to perform MSI and/or IHC testing for LS on tumor biopsies taken during colonoscopy?” Non-routinely ordering are the respondents who answer “0%”, “25%”, “50%” or “75%” of the time, and the routinely ordering are those respondents who answer “100%” of the time