September 23, 2010
Inconsistent use of a simple, reliable test to screen for early colorectal cancer may be compromising the tool's effectiveness in reducing death rates from the disease.
A new study finds that many patients who initiate stool blood testing do not complete subsequent screenings as recommended by screening guidelines.
Stool testing to detect microscopic amounts of blood has been endorsed worldwide for adults 50 and older. Trials have found that when performed annually or every other year, the test reduces colorectal cancer incidence and mortality by 33 percent.
Cost-effective tool
In the United States, colonoscopy is used more widely to screen for the disease, but stool blood testing -- at less than $25 per test -- is considered the more cost-effective method and is the key screening strategy for many health plans and for underserved and rural populations.
"Many patient and providers may not realize that this test needs to be repeated regularly to yield benefits, just like mammograms or Pap smears for women," says Joshua Fenton, assistant professor of family and community medicine at University of California at Davis.
Fenton and colleagues examined records of 11,000 patients enrolled in Group Health, a health plan based in Seattle, who had a stool blood test within a two-year period.
Follow-up on those patients found that nearly 50 percent did not repeat the test within the next two years, as recommended. Another eight percent had a different type of screening, such as sigmoidoscopy or colonoscopy.
Details of the study, which was funded by the National Cancer Institute and American Cancer Society Mentored Research Scholars Grant and by an HMO Cancer Research Network pilot grant, are published in the September/October issue of the journal Annals of Family Medicine.
