Utilization Pattern of Computed Tomographic Colonography in the United States: Analysis of the US National Health Interview Survey.

2020 
Computed tomographic (CT) colonography for colorectal cancer (CRC) screening has been proved to be effective and cost-saving. CT colonography uses minimally invasive evaluation of colorectum and has better patient acceptance, which appears to be a promising screening modality to improve low CRC screening rate. This study investigated the utilization patterns of CT colonography and factors associated with its use among US adult population. This retrospective cross-sectional study analyzed the National Health Interview Survey 2015 and 2018. US adults aged 45 or older without a history of CRC were included. Survey design-adjusted Wald F tests were used to compare the utilization of CT colonography during the study period. Multivariable logistic regression was used to identify the predictors of CT colonography among individual socioeconomic and health-related characteristics. The study sample included 34,768 individuals representing 129,430,319 US adult population aged 45 or older. The overall utilization of CT colonography increased from 0.79% in 2015 to 1.33% in 2018 (P<.001). 54.5% study participants reported being up-to-date on recommended CRC screening; of those, 1.8% used CT colonography. Compared to individuals aged 65+, those aged 45-49 years were 2.08 times (OR, 2.08, 95% CI, 1.01-4.35) more likely to use CT colonography. Socioeconomically disadvantaged characteristics (e.g., racial/ethnic minority, low income, publicly funded insurance) were associated with a greater likelihood of CT colonography. This study demonstrated an increasing trend in utilization of CT colonography for CRC screening in US adults. Younger individuals, racial/ethnic minorities, or those with lower income appear to have a higher CT colonography utilization.
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