Additional Colorectal Screening Tests Did Not Increase Screening Rates

A recent study examined the US Preventive Services Task Force (USPSTF) accepted colorectal cancer screening modalities and found that adding two additional screening tests to the current guidelines did not significantly influence the overall colorectal cancer screening rates within an academic primary care network. 

The USPSTF included multitarget stool DNA and CT colonography as accepted colorectal cancer screening modalities to the already recommended tests—FOBT/FIT, sigmoidoscopy and colonoscopy—in June of 2016. To determine the effect of the USPSTF update of adding two additional colorectal cancer screening tests on existing colorectal cancer screening modalities and on the overall colorectal cancer screening rates within an academic primary care network, a research team led by Mark Benson, MD, of the University of Wisconsin School of Medicine and Public Health, and colleagues, reviewed data on overall colorectal cancer screening rates and type of screening modality used.

The researchers identified 71,702 patients who were eligible for average risk screening in a primary care network during the study period. The researchers compared monthly overall colorectal cancer screening rates as well as the mean total numbers of multitarget stool DNA, colonoscopy, flexible sigmoidoscopy, CT colonography and FOBT/FIT for 50% to 75% of eligible patients from June 2016 until Sept 2017.

According to the findings, the overall percent of eligible patients screened for colorectal cancer within the primary care network did not significantly change during the study period (80.9 % vs 79.9 %;
P = 0.11). The researchers noted that there was a trend toward decreased use of screening colonoscopy but this did not reach statistical significance, 80.6% vs 77.7% (P = .06). The findings demonstrated no significant change in the use of FOBT/FIT, (9.3% vs 7.9%; P = 0.18), or flexible sigmoidoscopy,( 2.4% vs 1.6%; P = 0.13). However, the researchers did find a significant increase in the percent of patients screened with multitarget stool DNA from 4.6 % to 11.1% (P < .001), and a significant decrease in the percent of patients screened using CT colonography from 3.1% to 1.7% (P = 0.01).

Based on the findings, Dr Benson and his colleagues concluded that the addition of two colorectal cancer screening tests to the USPSTF guidelines did not significantly influence overall screening rates. Further, the majority of the colorectal screening completed continues to be with colonoscopy,although there was a trend toward decreased use during the study. 

This research was presented during Digestive Disease Week 2018.

—Julie Gould