UC Davis research finds inconsistent use of common cancer screening tool
September 17, 2010
(SACRAMENTO, Calif.) — 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, UC Davis researchers have found.
The study by Joshua Fenton, assistant professor of family and community medicine at UC Davis, and colleagues at UC Davis and at the University of Washington, found that many patients who initiate fecal occult blood testing, or stool blood testing, do not complete subsequent screenings as recommended by screening guidelines.
The study, "Longitudinal Adherence with Fecal Occult Blood Test Screening in Community Practice," was published online this week in the September/October issue of Annals of Family Medicine.
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. 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. Stool blood testing is the key screening strategy for many health plans and for underserved and rural populations.
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 8 percent had a different type of screening, such as sigmoidoscopy or colonoscopy.
"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 ," Fenton said, adding that he hopes the study spurs investment in interventions aimed at fostering high adherence to regular stool blood testing screening schedules.
The Center for Health Policy Research (formerly called the Center for Health Services Research in Primary Care) conducts research on health-care access, delivery, costs, outcomes and related health policy to improve the organization, quality and effectiveness of the practice of medicine, especially primary care. The Center is a resource for the university and health system on comparative effectiveness research. Center faculty conduct original research, offer consulting services to agencies in both public and private sectors, and provide research training to fellows, graduate students and junior faculty. Established as an interdisciplinary unit, the center includes more than 80 health-care researchers who represent disciplines ranging from business management and psychiatry to preventative medicine, epidemiology and statistics. For more information, visit www.ucdmc.ucdavis.edu/chpr.