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VA New England Healthcare System

 

Veterans' Healthy Living, Winter 2014

Screening for Colorectal Cancer: Which Method is Best?

Colorectal cancer is currently the second most common cause of cancer death in the United States, but it is also one of the most preventable cancers. VA researchers know that screening is an effective tool for reducing colorectal cancer deaths, but they are trying to determine which screening test is best.

Douglas J. Robertson, MD, MPH, Chief of Gastroenterology at the White River Junction VA, explains that one well-studied testing method is the use of a "stool card," which requires collecting a small amount of fecal matter at home once every year. The sample is then sent off and tested for evidence of blood. This test has been proven to reduce cancer deaths.

Another widely used but less studied test is the colonoscopy, during which a flexible scope is used to examine the colon. A colonoscopy is a more invasive test with higher risk and cost, but it affords the opportunity to directly examine the colon wall for polyps - a cancer precursor. Also, if the colonoscopy test is normal, no further testing is needed for 10 years.

"We want to find out if doing a colonoscopy on everybody reduces colorectal cancer mortality as much or more than the simpler use of a stool test every year," Robertson says. With the stool test, only those with evidence of blood in their sample need a colonoscopy.

"To do that, we’ll follow study participants for about 10 years to see if one method prevents more cancer deaths than the other does. It’s important to stress that both methods work to prevent death from colon cancer - we just want to know if one works better than the other."

Robertson says that the VA is currently recruiting 50,000 Veterans nationally for the study, and those who’ve signed up are already being tested. Within VISN 1, participating sites are Boston, West Haven, White River Junction, and Providence.

For more information, visit with your health care provider, or read more online at http://clinicaltrials.gov/show/NCT01239082.