Study finds colorectal cancer screening underused
Fewer than half of patients diagnosed had received
a screening
January 13, 2005 | For more information: George
Stamatis 216-368-3635
 Fewer than half of patients diagnosed with colorectal cancer had
received a screening procedure at least six months prior to their
diagnosis, according to a new study from the Case Western Reserve
University School of Medicine and University Hospitals of Cleveland
(UHC).
Researchers writing in the February 15, 2005, issue of Cancer,
a peer-reviewed journal of the American Cancer Society, further
say that almost 94 percent of colorectal cancer patients had either
not undergone a colonoscopy at all, or not until having the procedure
that led to their diagnosis. The article is published online today.
Professional societies unanimously recommend colorectal cancer
screening in older adults. The premise is mortality and morbidity
are reduced when a pre-malignant growth, which is generally at an
earlier stage, is detected and treated. Clinicians can use tests
from the simple fecal occult blood test (FOBT), the cheapest but
least sensitive test, to a direct examination of the colon with
a sigmoidoscopy, a colonoscopy or barium enema. The colonoscopy
is the most sensitive test.
In order to characterize the use of the various screening tests
in the population and their association with cancer stage, Gregory
S. Cooper, M.D., and Jonathan D. Payes, M.D., of Case and UHC, reviewed
the screening history and cancer stage of 5,806 elderly patients
diagnosed with colorectal cancer.
The authors found fewer than half (44 percent) of patients had
received at least one screening test more than six months prior
to diagnosis, and most often, that test was the FOBT. While colonoscopies
were the most common test overall (63 percent of patients), most
were done within six months of diagnosis. Only six percent were
performed prior to the six-month period before diagnosis. Patients
with a history of screening more than six months prior to diagnosis
had earlier stage and presumable more treatable disease.
The authors conclude, “we have highlighted the underuse of
colorectal procedures in clinical practice, which is relevant given
the high incidence and mortality of colorectal carcinoma in the
United States.”
Cooper is an associate professor of medicine and Payes is an analyst/programmer.
Both are in the division of gastroenterology at Case and UHC.
For more information about colon cancer, search http://www.netwellness.org,
a free consumer health Web site operated by Case, Ohio State University,
and the University of Cincinnati.
About Case Western Reserve University
Case is among the nation's leading research institutions. Founded in 1826
and shaped by the unique merger of the Case Institute of Technology and Western
Reserve University, Case is distinguished by its strengths in education, research,
service, and experiential learning. Located in Cleveland, Case offers nationally
recognized programs in the Arts and Sciences, Dental Medicine, Engineering,
Law, Management, Medicine, Nursing, and Social Work. http://www.case.edu.
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