Boost in CRC Screening after USPSTF Recommendation: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On October 4, 2024, we reported on findings from a study published in JAMA Network Open that examined changes in colorectal cancer (CRC) screening uptake among average-risk adults aged 45 to 49 years following the USPSTF recommendation issued in 2021.

The study

Investigators used deidentified commercial claims data from Blue Cross Blue Shield (BCBS) Axis to identify average-risk individuals aged 45 to 49 years across the US. They included 10 221 114 beneficiaries (mean age, 47 years; 51.04% women) and compared uptake 20 months before (May 2018-December 2019) and 20 months after (May 2021-December 2022); the USPSTF recommendation.

Of the cohort, 25.43% were White, 2.65% were Black, 3.86% were Hispanic, 1.15% were Asian, 0.15% were Native American or Pacific Islander, and 66.76% had unknown race and ethnicity.

The findings

Between the prerecommendation and postrecommendation periods, mean CRC screening uptake increased from 0.50% to 1.51% (P < .001) among average-risk beneficiaries. Although these individuals had a higher absolute change in screening compared to high-risk beneficiaries (1.01 percentage points [95% CI 0.62-1.40] vs 0.21 [95% CI 0.02-0.40]), average-risk persons had no significant relative change in screening (202.51%; 95% CI −30.59% to 436.87%).

Screening uptake increased the fastest after the USPSTF recommendation among those living in areas with the highest socioeconomic status (0.24 percentage points every 2 months, 95% CI 0.23-0.25), as well as among those in metropolitan areas (0.2 percentage points every 2 months, 95% CI 0.19-0.21).

In the subgroup analysis of average-risk beneficiaries with data on race and ethnicity, results showed significant increases in screening between the 2 periods in each group.

Authors' comment

"Although CRC screening was expectedly higher among high-risk individuals, the 2-fold increase in screening among average-risk beneficiaries suggests a shift in the screening paradigm of this newly included age group."

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