‘Virtual colonoscopy’ still struggling for mindshare
Two-thirds of U.S. adults eligible to get screened for colorectal cancer have recently completed an exam, but only 1.4% of them opted for CT colonography over optical colonoscopy or sigmoidoscopy, according to a study published online April 28 in JACR.
First author Brandon O’Connor, DO, of the University of the Incarnate Word in San Antonio, last author Anand Narayan, MD, PhD, of the University of Wisconsin and colleagues analyzed data from the 2019 National Health Interview Survey.
Focusing on a field of 13,709 respondents between 50 and 75 with no history of colorectal cancer, the researchers adjusted data selection and analysis to estimate national screening rates across modalities.
Some 67% of all respondents reported having a colonoscopy or sigmoidoscopy in the previous year. Of the 1.4% who had CT colonography, aka CTC or “virtual colonoscopy,” 39.9% underwent the procedure within a year prior to taking the survey. This compared with 18.5% within the two prior years, 13.0% within the prior three years and 7.8% within the prior five years.
O’Connor and co-authors also found utilization rates varying by race and ethnicity, as Black and Hispanic survey respondents were more likely than Whites to choose CTC over other colorectal screening options.
Hispanic participants were least likely among these three subpopulations to report undergoing colonoscopy or sigmoidoscopy.
The overall low rates of CTC screening, O’Connor and colleagues point out, are in line with those recorded in surveys dating back to 2010.
“The persistently low use of CTC is likely multifactorial, but previous studies have suggested that lack of insurance coverage by Medicare and many private payers for this recommended screening test may play a role,” the authors comment in their discussion section. “Additionally, our study found that patients who reported working the previous week were less likely to be screened with CTC. This suggests that time off from work may be a barrier, although CTC is less invasive than optical colonoscopy and has a lower rate of complications.”
Noting that CTC deserves greater consideration among patients concerned about convenience—it requires no sedation, dedicated driver or recovery time—O’Connor et al. call for more patient education about all colorectal screening choices.
More coverage of CT colonography:
Billionaire ‘Shark Tank’ investor Mark Cuban promotes CT colonography to millions of followers
American College of Radiology, patient advocacy groups urge feds to fix CTC coverage gap
CT colonography utilization remains low in US
ACR acquires searchable database of CT colonography centers
Reference:
Brandon O’Connor, Newman Kwame Boakye-Ansa, Corey A. Brown, Efren J. Flores, Andrew B. Ross, Maria D. Martin, Jessica B. Robbins, Anand K. Narayan, “Predictors of CT Colonography Use: Results From the 2019 National Health Interview Cross-Sectional Survey.” Journal of the American College of Radiology, April 28, 2022. DOI: https://www.jacr.org/article/S1546-1440(22)00283-6/fulltext
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.