National guidance recommending CTC for colorectal cancer screening sparked 50% jump in utilization

The U.S. Preventative Services Task Force updated its colorectal cancer screening recommendations in 2016. And the move has led to substantial gains in computed tomography colonography utilization rates.

That’s according to Harvey L. Neiman Health Policy Institute researchers who examined commercial claims data to pinpoint monthly screening figures, sharing their results in the American Journal of Preventative Medicine.

CTC rates had remained static prior to the USPSTF adding the exam to its list of recommended tests for colorectal cancer in June 2016, researchers noted in the March 19 study. But shortly after that date, utilization increased, ultimately ballooning by 50% between 2010 and 2018.

First author Steve Chen, MSPH, and colleagues had a few thoughts on what specifically triggered the jump.

“First, the recommendation and associated publicity signals evidence of CTC’s effectiveness” and may have caused a demand increase, Chen, with Emory University’s Department of Health Policy and Management, and co-authors wrote.

They added the USPSTF recommendation may have triggered the Affordable Care Act’s requirement mandating non-grandfathered health plans cover screening CTC without patient cost sharing by 2018.

To arrive at their conclusions, Chen et al. utilized IBM MarketScan claims for privately insured patients between 50 and 64 years over a nine-year period. During that time, more than 31 million individuals underwent 3,773 CTC exams.

While cost sharing for exams fell from 38.2% down to 10.2% between 2010 and 2016, monthly CTC utilization still hovered around 0.4 procedures per 100,000 people.

Immediately after the task force update, however, that rate jumped to 0.6 procedures per 100,000 individuals, the authors reported. The number did not move even after the ACA’s 2018 cost mandate.

All in all, Chen and colleagues found the jump in utilization, paired with recommendations for screening every 5 years, results in nearly 12 extra patients undergoing CTC exams per 100,000 people.

“The results of our study support the power of evidence-based recommendations to impact cancer screening rates among the U.S. privately insured population,” the authors concluded.

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