Although computed tomographic (CT) colonography has been proved to be cost-effective and have better patient acceptance, its overall utilization for colorectal cancer (CRC) screening is low (<1.4%) among US adults aged 45+ in 2018. More efforts are needed to implement strategies to increase CT colonography for effective CRC prevention. CT colonography for colorectal cancer screening has been proved to be effective and cost-saving. CT colonography uses minimally invasive evaluation of colorectum and has better patient acceptance, which appears to be a promising screening modality to improve low colorectal cancer screening rate. This study investigated the utilization patterns of CT colonography and factors associated with its use among U.S. adult population. This retrospective cross-sectional study analyzed the National Health Interview Survey 2015 and 2018. U.S. adults ages 45 or older without a history of colorectal cancer were included. Survey design-adjusted Wald F tests were used to compare the utilization of CT colonography during the study period. Multivariable logistic regression was used to identify the predictors of CT colonography among individual socioeconomic and health-related characteristics. The study sample included 34,768 individuals representing 129,430,319 U.S. adult population ages 45 or older. The overall utilization of CT colonography increased from 0.79% in 2015 to 1.33% in 2018 (P < 0.001). 54.5% study participants reported being up-to-date on recommended colorectal cancer screening; of those, 1.8% used CT colonography. Compared with individuals ages 65+, those ages 45–49 years were 2.08 times (OR, 2.08, 95% confidence interval, 1.01–4.35) more likely to use CT colonography. Socioeconomically disadvantaged characteristics (e.g., racial/ethnic minority, low income, publicly funded insurance) were associated with a greater likelihood of CT colonography. This study demonstrated an increasing trend in utilization of CT colonography for colorectal cancer screening in U.S. adults. Younger individuals, racial/ethnic minorities, or those with lower income appear to have a higher CT colonography utilization. Prevention Relevance: Although computed tomographic (CT) colonography has been proved to be cost-effective and have better patient acceptance, its overall utilization for colorectal cancer (CRC) screening is low (<1.4%) among US adults aged 45+ in 2018. More efforts are needed to implement strategies to increase CT colonography for effective CRC prevention.

中文翻译：

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美国计算机断层结肠成像的使用模式：美国国家健康访谈调查分析

尽管计算机断层扫描 (CT) 结肠成像已被证明具有成本效益并且具有更好的患者接受度，但 2018 年美国 45 岁以上成年人对结直肠癌 (CRC) 筛查的总体利用率较低 (<1.4%)。需要实施增加 CT 结肠造影以有效预防 CRC 的策略。用于结肠直肠癌筛查的 CT 结肠成像已被证明是有效且节省成本的。CT结肠成像采用微创评估结直肠癌，具有更好的患者接受度，这似乎是一种很有前途的筛查方式，可以提高结直肠癌的低筛查率。本研究调查了美国成年人群中 CT 结肠成像的使用模式以及与其使用相关的因素。这项回顾性横断面研究分析了 2015 年和 2018 年的全国健康访谈调查。纳入了 45 岁或以上没有结直肠癌病史的美国成年人。调查设计调整的 Wald F 检验用于比较研究期间 CT 结肠造影的利用率。多变量逻辑回归用于确定个体社会经济和健康相关特征中 CT 结肠造影的预测因子。研究样本包括 34,768 人，代表 129,430,319 名 45 岁或以上的美国成年人口。CT 结肠造影的总体利用率从 2015 年的 0.79% 增加到 2018 年的 1.33%（P < 0.001）。54.5% 的研究参与者报告了最新的推荐结直肠癌筛查；其中，1.8% 使用 CT 结肠造影。与 65 岁以上的人相比，那些 45-49 岁的人使用 CT 结肠成像的可能性是 2.08 倍（OR，2.08，95% 置信区间，1.01-4.35）。社会经济弱势特征（例如，种族/族裔少数、低收入、公共资助的保险）与 CT 结肠造影的可能性更大有关。这项研究表明，在美国成年人中，CT 结肠成像在结直肠癌筛查中的应用呈增加趋势。年轻人、种族/少数民族或收入较低的人似乎有更高的 CT 结肠成像利用率。预防相关性：尽管计算机断层扫描 (CT) 结肠造影已被证明具有成本效益并且具有更好的患者接受度，但 2018 年美国 45 岁以上成年人的结肠直肠癌 (CRC) 筛查总体利用率较低 (<1.4%)。