Impact of COVID-19 on colorectal cancer screening using Medicare Centers for Medicare and Medicaid Services (CMS) claims data.

Abstract

91 Background: When COVID-19 pandemic started in 2020 in the US, the Centers for Medicare and Medicaid Services (CMS) recommended that all non-urgent procedures, including screening colonoscopies, be delayed until pandemic stabilization. This was done to prevent the spread of the virus via colonoscopy since the presence of the virus in fecal samples has been reported in infected patients. Little is known of the impact of COVID-19 on the number of colorectal cancer (CRC) screening performed in the US. Methods: We utilized the Centers for Medicare & Medicaid Services Database which provides Medicare claims data for 2013-2022. We searched “Medicare Physician & Other Practitioners - by Geography and Service” using CPT code for colonoscopy(G0121, G0105), fecal occult blood test (FOBT; G0328, 82270), stool-based gene analysis (81528), sigmoidoscopy (G0104), and barium enema (G0120) and collected the number of CRC screening claims at national level and calculated the year-over-year (YOY) change. Results: The number of CRC screening claims in the US from 2013 to 2022 is listed (Table). The total number of CRC screening claims increased an average of 0.5% YOY from 2014 to 2019 then decreased 23.4% in 2020. From 2014 to 2019, the average YOY change in colonoscopy, FOBT, stool-based gene analysis, sigmoidoscopy, and barium enema claims were -0.5%, -6.0%, 58.7%, 8.1%, and -6.0%, respectively whereas in 2020, the rates were -27.5%, -25.0%, -14.4%, -25.3%, and -1.7%, respectively. The total number of CRC screening claims in year 2021 and 2022 increased from 2020, however, was still lower than 2019. Conclusions: CRC screening claims decreased in the US in 2020 likely due to COVID-19 and not yet returned to pre-pandemic levels. Number of CRC screening claims in the US from 2013 to 2022. Screening test 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 　 Colonoscopy 759,883 736,400 743,873 765,974 767,063 755,806 736,247 533,972 685,439 707,672 　 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 　 Stool-Based Gene analysis 　 　 　 123,748 231,765 335,459 482,761 413,224 497,748 536,348 　 Sigmoidoscopy 2,666 2,316 3,254 3,390 3,835 3,784 3,975 2,968 3,893 3,680 　 Barium enema 107 93 80 116 128 97 58 57 44 65 　 Total CRC screening 2,069,710 2,002,411 1,908,421 2,023,358 2,088,568 2,091,162 2,121,034 1,623,835 1,833,674 1,804,715 　 Data are expressed in numbers (N). CRC; colorectal cancer; FOBT; fecal occult blood test.