Colon cancer tests underused

NEWS IN BRIEF — Posted June 19, 2006

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More than 40% of patients who initially had received a positive result on a fecal occult blood test for colon cancer did not receive appropriate diagnostic follow-up tests such as a colonoscopy or barium enema, according to a study published in the May Diseases of the Colon & Rectum. Researchers analyzed nearly 40,000 Veterans Affairs patient records in arriving at their conclusions.

The study even may underestimate the lack of follow-up in the country at large because the VA's level of preventive care and follow-up traditionally has been higher than at most health care settings, the study's authors said. Overall, 61% of eligible VA patients had been screened for colorectal cancer, a rate significantly higher than the national average. Of the screened population, 313 patients had an abnormal FOBT result. Of this group, only 59%, or 185 patients, received follow-up diagnostic tests. Forty-one percent, or 128 patients, got no follow-up at all in the six months following the initial screening.

The study has implications for how health care systems monitor their own quality, the authors say. "Any health care system that provides cancer screening programs needs to track each step in the screening process," said principal investigator David A. Etzioni, MD, a Robert Wood Johnson Clinical Scholar in the Division of General Surgery at the David Geffen School of Medicine at the University of California, Los Angeles.

Note: This item originally appeared at

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