Current practices may be leading to too much screening for colorectal cancer in older patients and poor efforts to determine and prompt appropriate follow-up testing, according to this novel study.
The Fecal Occult Blood Test (FOBT) is a low-risk screening test for colorectal cancer. This prospective study looked at 2,410 patients, 70 years or older and without significant colon issues, who were screened with FOBT at four Veterans Affairs (VA) medical centers during 2001. But unlike previous research, this study looked beyond VA records to Medicare and medical records to detect follow-up testing within one year post-FOBT. Patients are screened with three FOBT cards: a test is considered positive if any cards are positive; negative if all three cards are clear; and incomplete if fewer than three cards are submitted and all are negative.
The authors conclude quality improvement initiatives are needed to prompt more individualized decision-making regarding screening and follow-up testing for colorectal cancer in older patients.