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Study Finds Colonoscopy Still Underused in Veterans

Another study questions use of colonoscopy in younger patients with comorbidity and poor life expectancy

FRIDAY, Nov. 17 (HealthDay News) -- Although colonoscopy usage has significantly increased over the past several years, fecal occult blood testing dominates colorectal cancer (CRC) testing in veterans, one study finds, while another questions the benefit of colorectal screening in younger patients with reduced life expectancy. Both studies are published in the Nov. 13 Archives of Internal Medicine.

Hashem B. El-Serag, M.D., of Baylor College of Medicine in Houston, and colleagues evaluated 1998-2003 Veterans Administration CRC screening methods data and found that while the total number of colonoscopies increased from 24,955 in 1998 to 55,199 in 2003, the proportion of subjects screened with colonoscopy declined from 5.7 percent to 4.7 percent and fecal occult blood testing increased from 81.7 percent to 90.4 percent.

"It is likely that CRC screening with fecal occult blood testing will result in poorer clinical outcomes for veterans," according to an accompanying editorial.

In another Veterans Affairs study using 1996-2004 data, Shahnaz Sultan, M.D., of Duke University in Durham, N.C., and colleagues found that of 861 young patients (defined as patients 50 to 64 years of age), 45.9 percent had CRC testing within five years. Of these, screening was high in patients with moderate (44.9 percent) and severe (45.8 percent) comorbidities. Of the 52 patients who died during the five-year follow-up, 71.2 percent (37 patients) had CRC screening.

"Comprehensive assessment of health status and comorbidity should guide cancer screening decisions, especially in individuals with reduced life expectancy who may obtain the least benefit from screening," the authors conclude.

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