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

CT colonography for colorectal cancer 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 colorectal cancer screening rate. This study investigated the utilization patterns of CT colonography and factors associated with its use among U.S. adult population. This retrospective cross-sectional study analyzed the National Health Interview Survey 2015 and 2018. U.S. adults ages 45 or older without a history of colorectal cancer 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 U.S. adult population ages 45 or older. The overall utilization of CT colonography increased from 0.79% in 2015 to 1.33% in 2018 (P < 0.001). 54.5% study participants reported being up-to-date on recommended colorectal cancer screening; of those, 1.8% used CT colonography. Compared with individuals ages 65+, those ages 45-49 years were 2.08 times (OR, 2.08, 95% confidence interval, 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 colorectal cancer screening in U.S. adults. Younger individuals, racial/ethnic minorities, or those with lower income appear to have a higher CT colonography utilization. Prevention Relevance: Although computed tomographic (CT) colonography has been proved to be cost-effective and have better patient acceptance, its overall utilization for colorectal cancer (CRC) screening is low (<1.4%) among US adults aged 45+ in 2018. More efforts are needed to implement strategies to increase CT colonography for effective CRC prevention.