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Studies Examine Colorectal Cancer Screening Rates

The rate of colorectal cancer screening appears to be increasing among Veterans Affairs patients, although use of colonoscopy is less common than other screening procedures// , according to a report. A second report in the same journal shows that younger veterans with other illnesses and reduced life expectancies may not necessarily benefit from such screening and may even be harmed, but continue to be screened at high rates.

About 145,290 U.S. individuals developed colorectal cancer in 2005 and 56,290 died from the disease, according to background information in the first article. Screening for the disease has been shown to decrease illness and death. Methods include fecal occult blood testing (FOBT), which monitors for hidden blood in the stools, and colonoscopy, in which the large intestine (colon) is examined using a long flexible instrument known as a colonoscope. “Because it is the most invasive and costly approach and because it is usually performed by specialists, until recently, colonoscopy was primarily used to screen high-risk individuals, for diagnostic purposes or to follow up on abnormal results of other screening tests,” the authors write. However, because it can examine the whole colon and remove potentially cancerous growths at the same session, colonoscopy is increasingly common as indicated by data from Medicare and other health care systems and is recommended as the most accurate screening tool by a growing number of professional organizations.

Hashem B. El-Serag, M.D., M.P.H., of the Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, and colleagues studied screening patterns in patients who received care in the Department of Veterans Affairs between 1998 and 2003. By searching national inpatient and outpatient VA databases, the researchers identified all patients age 49 to 75 who had undergone FOBT, colonoscopy, a test known as flexible sigmoidoscopy, or double contrast barium enema, another scre
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