April 9, 2009

Colorectal Cancer Screening: Too Much, Too Late?

We all know colorectal cancer screening saves lives. According to current recommendations, however, there's a limit to the good these tests can do.

Many doctors haven't gotten that message, report Veterans Affairs researchers.

They note standard guidelines clearly state people who are not expected to live more than another four years generally don't need to undergo the tests. Their study of the medical records of more than 27,000 patients in the VA system finds little evidence anyone is following that advice.

The research specifically looked at patients who were age 70 or older and had been screened at one of four VA medical centers in 2001 and 2002. No evidence was found to suggest doctors were only screening the healthier people in the group "“ sicker people less likely to live much longer were screened at about the same rate as people who were doing well and thus looking at a longer life expectancy.

What will it take to get doctors to fall in line with the current recommendations? These authors suggest the guidelines should do a better job of explaining which combinations of age and medical conditions are most likely to lead people to die within five years. Then doctors and patients alike would be better able to determine who could really benefit from colorectal cancer screening, and who could be sparred the testing.

SOURCE: Archives of Internal Medicine, published online April 6, 2009