University of Wisconsin–Madison Medical College of Wisconsin

Colorectal Cancer Screening After Changes in US Preventive Services Task Force Guidelines With Increased Screening Options

Mark Benson, MD; Andrew Johannes, MD; Jennifer M. Weiss, MD, MS; Michael Lucey, MD; Jeff Pier, BS; Patrick Pfau, MD

WMJ. 2021;120(2):127-130.

Download full text pdf.


Introduction: In 2016, the US Preventive Services Task Force (USPSTF) added multitarget stool DNA and computed tomography colonography (CTC) as accepted colorectal cancer screening modalities to the already recommended tests: fecal immunochemical test (FIT), sigmoidoscopy, and colonoscopy. The aim of our study was to determine trends in screening after the USPSTF update, with the effect of additional tests on the use of existing colorectal cancer screening modalities and overall screening rates.

Methods: We prospectively compared monthly colorectal cancer overall screening rates and the mean total numbers of patients screened by multitarget stool DNA, colonoscopy, sigmoidoscopy, CTC, and FIT 6 months prior to the new USPSTF guidelines until 30 months after.

Results: At completion of the study, 72,202 patients were eligible for screening. The overall rate of eligible patients screened for colorectal cancer did not change (80.9% vs 81.3%; P = 0.287). There was a significant increase in the percent of patients screened with multitarget stool DNA (1.6% to 15.6%; P = .001) and a significant decrease in the percent of patients screened using CTC (3.8 % to 1.5%; P = .004), FIT (9.3% to 4.9%; P = .003), and sigmoidoscopy (2.4% to 1.5%, P = .024). There was a nonsignificant decrease in the percent use of screening colonoscopy, from 82.9 % to 76.5% (P = .313).

Conclusion: While the overall colorectal cancer screening rate did not increase after the USPSTF update with additional recommended screening tests, practice patterns did change with a shift in the type of screening test used.

Author Affiliations: University of Wisconsin School of Medicine and Public Health, Division of Gastroenterology and Hepatology, Department of Medicine, Madison, Wisconsin (Benson, Johannes, Weiss, Lucey, Pier, Pfau).
Corresponding Author: Patrick Pfau, MD, Professor of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave, Madison, WI 53705; phone 608. 263.7322; email
Funding/Support: None declared.
Financial Disclosures: None declared.
Share WMJ