Follow-up of colorectal CA screens lacking in older patients

(HealthDay)—A considerable proportion of older patients are not up-to-date with colorectal cancer screening and do not receive timely follow-up of abnormal fecal blood tests, according to a study published online June 22 in the American Journal of Preventive Medicine.

Carrie N. Klabunde, Ph.D., from the National Institutes of Health in Rockville, Md., and colleagues conducted a population-based longitudinal study among health plan members (aged 65 to 89 years) enrolled in three health care systems participating in the Population-Based Research Optimizing Screening through Personalized Regimens consortium. Data were included for 846,267 patients.

The researchers found that 72 percent of patients were up-to-date with colorectal cancer screening. Sixty-five percent of those with a positive fecal blood test received follow-up colonoscopy within three months. Compared with younger participants, patients aged 76 years or older had a significantly lower likelihood of being up-to-date and receiving timely follow-up (P < 0.001). The influence of comorbidity was less than that of age, and had a stronger correlation with timely follow-up than with being up-to-date. A considerable number of patients with no/low comorbidity were not up-to-date or did not receive timely follow-up in all age groups.

"In three integrated health care systems, many older, relatively healthy patients were not screening up-to-date, and some relatively young, healthy patients did not receive timely follow-up," the authors write. "Findings suggest a need for reevaluating age-based screening guidelines and improving screening completion among the elderly."

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