Institutional Commitment to Rectal Cancer Screening Results in Earlier-Stage Cancers on Diagnosis

Abstract

These data suggest that a monitored institutional directive may significantly increase early detection of rectal cancers. This should result in a greater survival rate and lower local recurrence rate, because survival is predicated on stage at presentation. This may serve as a model for other health-care systems.

Care within a Veterans Hospital

“…We detect no significant change in the proportion of proximal versus distal lesions in our cohort over time. However, the more dramatic improvement of rectal cancer stage at presentation reported previously [2], as well as the significant relationship between stage at presentation and anatomic location that emerges from our data post-initiative, suggests that increasing screening rates using non-total colonic examination modalities may selectively benefit detection of rectal and more distal colon cancers.…”

“…Prior analysis of PAVAHCS data demonstrated a significant increase in the proportion of rectal cancers detected at early stages after implementation of the national VAHCS colorectal cancer screening initiative [2]. Additionally, a decrease was observed in the percentage of stage III rectal cancers.…”

“…Prior to the 1998 initiative, screening rates at the PAVAHCS ranged from 30% in 1996 to 55% in 1998, which exceeded the community standard at that time. Post-initiative, monitored screening rates rose to approximately 75% by the year 2000 [2,29].…”

“…We further evaluate all-cause 5-year patient survival and assess the percentage of cancers truly detected by screening. Our hypothesis, based on prior analysis of rectal cancers in the PAVAHCS [2], is that a monitored institutional standard of colorectal cancer screening will result in earlier detection of colon cancers and improved patient outcomes.…”

Population‐based programs for increasing colorectal cancer screening in the United States

“…The purpose was to collect data on CRC care, from diagnosis to treatment, and to enhance focus on improving the complete screening process, ie, if FOBT is a first screening step, then getting a CS after a positive FOBT should be part of the standard screening process. Reports from specific hospitals demonstrated an improvement in diagnosis of early stage CRC . The screening rates markedly improved from 31% (2001) to 80% (2009) .…”