CTC Usage Jumps 50 Percent with USPSTF Guidance

March 27, 2021
Whitney J. Palmer

The 2016 recommendation has led to a significant increase in the use of the non-invasive exam.

CT colonography (CTC) use is on the upswing thanks in large part to changes from the U.S. Preventive Services Task Force (USPSTF) in 2016.

According to an analysis from the Harvey L. Neiman Health Policy Institute, published in the American Journal of Preventive Medicine, CTC rates sky-rocketed 50 percent between 2010 and 2018. Much of those gains were seen after the USPSTF put the test on its list of recommended colorectal cancer screening exams in June 2016.

Based on their review, said first author Steve Chen, MSPH, a graduate of the Emory University Rollins School of Public Health, the recommendation could have had two impacts on screening rates.

Related Content: CT Colonography Tops List for Non-Invasive Advanced Neoplasia Targeting

“First, the recommendation and associated publicity signals evidence of CTC’s effectiveness, potentially leading to increased service demand,” he said. “Second, the recommendation triggered the [Affordable Care Act]’s requirement that non-grandfathered health plans fully cover screening CTC without patient cost sharing by 2018.”

For their study, Chen’s team examined nine years of IBM MarketScan claims for patients between ages 50 and 64 who were privately insured. During that timeframe, 31 million patients underwent 3,773 CTC scans.

Between 2010 and 2016, according to their analysis, cost sharing for exams declined from 38.2 percent to 10.2 percent while monthly CTC usage remained relatively constant around 0.4 procedures per 100,000 patients.

Related Content: CT Colonography Identifies Pre-Malignant Polyps with Machine-Based Learning Algorithm

Once the USPSTF released its recommendation, though, the utilization rate increased to 0.6 exams per 100,000 individuals, they said, and it remained consistent even after the Affordable Care Act’s 2018 cost mandate.

Given that CTC screenings are recommended every five years, the team said, the result is an additional 12 patients per 100,000 people undergoing the exam.

“In an environment of already largely eliminated patient cost sharing, the release of supportive evidence-based recommendations by a recognized credible body was associated with an immediate increase in CTC use for colorectal cancer screening,” said senior author Michal Horny, Ph.D., assistant professor at Emory University School of Medicine. “The results of our study support the power of evidence-based recommendations to impact cancer screening rates among the U.S. privately insured population.”

For more coverage based on industry expert insights and research, subscribe to the Diagnostic Imaging e-Newsletter here.