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VA Research Currents archive
Posted December 9, 2013
Researchers with VA and the University of Iowa College of Public Health found that mailing stool tests to Veterans' homes—rather than waiting for them to be screened during office visits—was an effective measure for preventing colorectal cancer.
Dr. Richard Hoffman, with VA and the University of New Mexico, shows a stool-test kit used in an earlier VA study. A new VA study out of Iowa has now provided further evidence that mailing test kits to Veterans' homes may be an effective way to screen for colorectal cancer. (Photo courtesy of Albuquerque VA Medical Center)
Some 1,500 Veterans between 51 and 64 years old who were overdue for colorectal screening were divided into three groups. One group received educational material in the mail; another was mailed the educational material and a fecal immunochemical test, or FIT. The FIT, a home screening test recently adopted by VA, detects human blood in stool. It requires only one sample and is thought to be more accurate than other types of stool tests. The last group served as the control and received neither the kits nor the educational material.
The Veterans assigned to either the FIT or educational group initially received a letter explaining the study, along with consent forms, an eligibility screen, and a survey. Those in the FIT group also received a FIT kit with instructions. Of the FIT group, 21 percent returned the consent and eligibility screen. Some of the respondents were ruled out because of medical history or current symptoms, leaving 71 participants eligible to take the test.
Of these, 90 percent completed the test. Twelve percent of the tests came back positive, and those patients were referred for further diagnostic testing and care.
Overall, 21 percent of the total FIT group underwent screens by any method within six months of the mailing, while only six percent in each of the other two groups received colorectal cancer screens during the study.
The findings suggest that mailing screening kits, versus waiting to screen patients during routine primary care visits, may be a more effective method to prevent colorectal cancer, particularly for rural Veterans.
The results jibe with those from a similar VA study published in 2011 in the American Journal of Care. That study, led by a team with VA and the University of New Mexico, used a different type of colorectal cancer screening kit but also found the mail method to be more effective than waiting for patients to be screened during office visits.
Colorectal cancer is the third most common cancer in the U.S. and the third leading cause of cancer-related deaths. In the VA health system, there are some 4,000 new cases each year. Research has shown that annual screening with a FIT or through other periodic tests, such as colonoscopy, can decrease colorectal cancer mortality substantially.
The Journal of Rural Health, Oct. 25, 2013