87 Background: In March 2020, the Centers for Medicare & Medicaid Services (CMS) recommended delaying non-urgent procedures, including screening colonoscopies, to minimize COVID-19 transmission. This led to nationwide delays in colorectal cancer (CRC) screening, with sharp declines in 2020 and incomplete recovery by 2022. With updated Medicare claims data through 2023, we assessed trends in CRC screening utilization. Methods: We analyzed CMS claims data from 2013-2023 using CPT codes for colonoscopy, fecal occult blood test (FOBT), stool-based DNA testing, sigmoidoscopy, and barium enema. Annual claims and year-over-year (YOY) changes were evaluated. Results: From 2013-2019, total CRC screening claims were stable at about 2 million annually, with modest average YOY growth of 0.5%. Total claims declined from 2,121,034 in 2019 to 1,623,835 in 2020, a 23.4% decrease. By 2023, volumes partially recovered to 1,911,484 but remained 9.9% below 2019. Colonoscopy, accounting for 35-37% of claims pre-pandemic, declined from 736,247 to 533,972 in 2020 (27.5% decrease) but rebounded to 732,763 in 2023, nearing baseline. FOBT, once the most common modality with 1,307,054 claims in 2013, steadily declined to 485,184 in 2023, a 62.9% reduction. In contrast, stool-based DNA testing grew rapidly after its introduction in 2016, rising from 123,748 claims to 689,488 by 2023 and exceeding FOBT. Sigmoidoscopy (<4,000 annually) and barium enema (<150 annually) remained rare. Conclusions: Although CRC screening volumes have rebounded since the pandemic, they remain nearly 10% below pre-pandemic levels, indicating persistent gaps in preventive care. Despite deferred screening cases during the pandemic and updated guidelines recommending that screening begin at age 45, the rebound has not met expectations through 2023. Further studies are needed to investigate possible causes, including limited screening capacity, inadequate patient and provider education, and healthcare policy/insurance factors. Additionally, the sharp decline in FOBT and the rise of stool-based DNA testing reflect an ongoing transition toward newer, non-invasive screening modalities. Number of CRC screening claims in the US from 2013 to 2023. Screening test 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Colonoscopy 759,883 736,400 743,873 765,974 767,063 755,806 736,247 533,972 685,439 707,672 732,763 FOBT 1,307,054 1,263,602 1,161,214 1,130,130 1,085,777 996,016 897,993 673,614 646,550 556,950 485,184 Gene analysis 123,748 231,765 335,459 482,761 413,224 497,748 536,348 689,488 Sigmoidoscopy 2,666 2,316 3,254 3,390 3,835 3,784 3,975 2,968 3,893 3,680 4,016 Barium enema 107 93 80 116 128 97 58 57 44 65 33 Total CRC screening 2,069,710 2,002,411 1,908,421 <jats:td colspa
Lim et al. (Sat,) studied this question.