Evolving trends in CT colonography: A 10-year analysis of use and associated factors

Abstract

Purpose

Computed tomographic colonography (CTC) is a non-invasive screening test for colorectal cancer (CRC) with high sensitivity and low risk of complications. We used a nationally representative sample of screening-eligible adults to examine trends in and factors associated with CTC use.

Methods

We examined CTC use among 58,058 adults in the National Health Interview Survey in 2010, 2015, 2018, 2019, and 2021. For each survey year, we estimated CTC use by sociodemographic and health factors. We used multivariable logistic regression to identify factors associated with CTC use.

Results

A total of 1.7 % adults reported receiving CTC across all survey years. CTC use was similar in 2010 (1.3 %), 2015 (0.8 %), 2018 (1.4 %), and 2019 (1.4 %) but increased in 2021 (3.5 %, p < 0.05). In multivariable analysis, survey year 2021 [vs. 2010, odds ratio (OR) 2.51, 95 % confidence interval (CI) 1.83–3.43], Hispanic (OR 1.73, 95 % CI 1.34–2.23), non-Hispanic Black (OR 2.07, 95 % CI 1.67–2.57), and household income <200 % federal poverty level (vs. >400 %, OR 1.25, 95 % CI 1.01–1.57) was associated with CTC use. Further, adults with a history of diabetes (OR 1.20, 95 % CI 1.01–1.45), chronic obstructive pulmonary disease (OR 1.58, 95 % CI 1.25–1.99), cancer (OR 1.29, 95 % CI 1.05–1.58), or past-year hospital admissions (OR 1.44, 95 % CI 1.18–1.78) were more likely to receive CTC.

Conclusion

CTC use remained low from 2010 to 2019 but increased in 2021. CTC use was more frequent among adults with chronic health conditions, minorities, and adults with lower income, and may help reduce disparities in CRC screening.