Patterns of initial colorectal cancer screenings after turning 50 years old and follow-up rates of colonoscopy after positive stool-based testing among the average-risk population

作者：George I. Austin, Henrik Kowalkowski, Yinglong Guo, Lesley‐Ann Miller‐Wilson, Stacey DaCosta Byfield, Prat Verma, Laura Housman, Ethan M. Berke · 发表于：Current Medical Research and Opinion · 年份：2022 · DOI：10.1080/03007995.2022.2116172 · 被引用次数：16 · 研究领域：Colorectal Cancer Screening and Detection、Helicobacter pylori-related gastroenterology studies、Microscopic Colitis

Objectives Effective colorectal cancer (CRC) screening requires proper adherence beginning at the recommended screening age. For those with positive results on stool-based tests (SBTs), a follow-up colonoscopy is warranted. The objectives of this study were to 1) examine initial screening rates after turning 50 years old; and 2) assess rates of follow-up colonoscopy after a positive SBT.Methods This retrospective study used de-identified administrative claims data from 01/01/2006 to 06/30/2020 for commercially insured and Medicare Advantage enrollees. For objective 1, the index year was the year enrollees turned 50. Rates of CRC screening during and after the index year were captured. For objective 2, the index date was the claim date of a fecal immunochemical test (FIT) or multitarget stool DNA test (mt-sDNA) where linked lab data indicated a positive test result. Rates and time to follow-up colonoscopy after a positive SBT were assessed.Results Approximately 53% of enrollees initiated CRC screening within five years after turning 50 (50+ cohort N = 718,562). Among enrollees with an available lab result indicating a positive SBT (N = 7329; 2110 FIT and 5219 mt-sDNA), overall follow-up colonoscopy within 6 months of the positive result was less than optimal (65%) and varied by modality; 72% vs 46% (p < .001) among enrollees with a positive mt-sDNA test compared to FIT test, respectively.Conclusion There is potential for improving CRC screening among the eligible average-risk ...