Objective:
To assess how the use of different colorectal cancer (CRC) screening methods changed in the U.S. between 2017 and 2024 among privately insured adults aged 50–75.
Study Design:
A retrospective cohort study of ~25 million Blue Cross Blue Shield beneficiaries using claims data from 2017–2024, comparing the pre-COVID (2017–Feb 2020) and post-COVID (July 2020–Dec 2024) periods.
Key Findings:
- Overall Trends:
- Colonoscopy and fecal immunochemical test (FIT) use decreased after COVID-19.
- Stool DNA test (e.g., Cologuard) use increased significantly during the same period.
- Colonoscopy and fecal immunochemical test (FIT) use decreased after COVID-19.
- By Sex:
- Males: Higher use of colonoscopy.
- Females: Higher use of stool DNA test and FIT.
- Males: Higher use of colonoscopy.
- By Socioeconomic Status (SES):
- High-SES areas: Greater use of colonoscopy and stool DNA tests, lower use of FIT.
- Low-SES areas: Relied more on FIT.
- High-SES areas: Greater use of colonoscopy and stool DNA tests, lower use of FIT.
- By Geography:
- Metropolitan residents: More frequent colonoscopy and FIT screening.
- Nonmetropolitan residents: Slightly higher use of stool DNA test, though the difference was not significant.
- Metropolitan residents: More frequent colonoscopy and FIT screening.