Is CTC effectively used for colon cancer screening?

A team led by Dr. Brandon O’Connor of the Embodied Word University of Osteopathic Medicine in San Antonio, TX, found that in 2019 the annual rate of CTC use among eligible individuals was only 1.4% – suggesting that efforts to boost CTC screening are badly needed, the group wrote.

“Patient education about CTC and other colorectal cancers [screening] available modalities can help reduce barriers to colorectal cancer screening,” the team noted.

In 2018, the US Preventive Services Task Force (USPSTF) lowered the age at which colon cancer screening begins from 50 to 45, expanding the pool of eligible people. Colon cancer screening can be done by CTC, fecal occult blood or immunochemical tests, flexible sigmoidoscopy and colonoscopy, but the advantage of CTC is that it is minimally invasive and very sensitive in detecting colon polyps.

Yet nearly a third of the eligible U.S. population does not receive the recommended colorectal cancer screening, O’Connor’s team explained. And this lack of uptake in screening can have particularly negative effects on underserved populations.

“[Underutilization of CTC] particularly affects racial and ethnic minority groups who face higher colorectal cancer mortality and are less likely to receive recommended screening compared to non-Hispanic whites,” the group wrote. “Increasing participation rates in colorectal cancer screening is a fundamental step in addressing existing disparities in cancer outcomes through early detection among underserved populations.”

O’Connor and colleagues sought to assess CTC use nationwide and identify any predictors of its use using data from the 2019 National Health Survey. included 13,709 respondents, of whom only 1.4% reported having undergone a CTC for colorectal cancer screening.

The group found that Latinx and black people were actually more likely to undergo CTC (rather than other forms of colorectal cancer screening) compared to their white counterparts.

Probabilities of using CTCs by race/ethnicity
Race/ethnicity Odds ratio (reference, 1)
White Reference
Latinx 2.67
Black 2.47
Native American or Alaska Native 1.28
Other 1.17
Asian 0.51

But the finding that blacks are more likely to experience CTC doesn’t change the fact that death rates among blacks, in particular, remain high.

“Colorectal cancer incidence and mortality rates are highest among black populations, suggesting that targeted interventions to improve screening rates in this at-risk population could reduce disease-specific mortality,” they wrote. writes O’Connor and his colleagues.

Previous studies have shown that patients often prefer CTC over other colon cancer screening tools because it is less invasive, the authors said.

“[One study] found that patients who had both optical colonoscopy and CTC preferred CTC, and in future screenings they would be more likely to choose [it]“, they concluded. “Not only is CTC better for patients, but it may also provide a more accessible option for patients.

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