Medicare now pays for more stool-DNA screening tests than screening colonoscopies — an estimated 1,451,000 to 1,220,000 in 2024
A few years ago the gap ran the other way. The multi-target stool-DNA test was far smaller in 2016 — an estimated 202,000 tests — and by the scaled estimate the two methods first cross for good only in 2022.
The stool test rose sharply while the colonoscopy side slipped. Screening colonoscopy ran an estimated 994,000 in 2016 and has drifted down since, while stool-DNA testing climbed off a small base.
Part of the crossing is a denominator effect specific to Medicare. Fee-for-service screening-colonoscopy volume is shrinking partly because beneficiaries are moving into Medicare Advantage, which this fee-for-service record does not capture. Some of the crossing reflects that falling denominator, not only stool testing rising.
On the raw fee-for-service record the two ran nearly even. As late as 2024 it showed about 625,000 stool-DNA to 608,000 screening colonoscopies; the scaled series cross earlier because the stool test's estimate leans on a single billing state.
A volume record, not a verdict on which method screens better — screening choice depends on the patient, and this page compares no outcomes.
Estimated total-Medicare colorectal-cancer SCREENING by method — multi-target stool-DNA and screening colonoscopy — 2016 to 2024.
Not a comparison to all colonoscopy (screening codes only; diagnostic and therapeutic colonoscopy are excluded and far larger), not billed claim lines, not a clean substitution, and not all-payer.