Skip to main content
Erschienen in: Surgical Endoscopy 8/2007

01.08.2007

Care within a Veterans Hospital

Earlier detection of colon cancer

verfasst von: P. van Roessel, R. V. Rouse, S. M. Wren

Erschienen in: Surgical Endoscopy | Ausgabe 8/2007

Einloggen, um Zugang zu erhalten

Abstract

Background

In 1998 the Veterans Administration mandated an externally monitored targeted colon cancer screening rate that was expected to result in earlier cancer detection and improved patient survival. The effectiveness of the protocol was evaluated in a retrospective case series at a tertiary care Veterans Administration Hospital that included all patients with the diagnosis of colon cancer between 1991 and 2003.

Methods

Tumor stage, tumor location, and patient survival data were recorded and compared to National Cancer Data Base (NCDB) benchmarks.

Results

The study facility had a greater percentage of early cancers and fewer later stage cancers than the NCDB benchmark. Overall survival was better for the VA cohort compared to NCDB (all-cause 5-year survival: VA, 0.72; NCDB, 0.47. p ≤ .001).

Conclusions

The VA facility had a significantly greater percentage of early cancers and fewer stage III or IV cancers compared to a national benchmark and significantly improved survival compared to the national benchmark.
Literatur
1.
Zurück zum Zitat Asch SM, McGlynn EA, Hogan MM, Hayward RA, Shekelle P, Rubenstein L, Keesey J, Adams J, Kerr EA (2004) Comparison of quality of care for patients in the Veterans Health Administration and patients in a national sample. Ann Intern Med 141: 938–945PubMed Asch SM, McGlynn EA, Hogan MM, Hayward RA, Shekelle P, Rubenstein L, Keesey J, Adams J, Kerr EA (2004) Comparison of quality of care for patients in the Veterans Health Administration and patients in a national sample. Ann Intern Med 141: 938–945PubMed
2.
Zurück zum Zitat Battat AC, Rouse RV, Dempsey L, Safadi BY, Wren SM (2004) Institutional commitment to rectal cancer screening results in earlier-stage cancers on diagnosis. Ann Surg Oncol 11: 970–976PubMedCrossRef Battat AC, Rouse RV, Dempsey L, Safadi BY, Wren SM (2004) Institutional commitment to rectal cancer screening results in earlier-stage cancers on diagnosis. Ann Surg Oncol 11: 970–976PubMedCrossRef
3.
Zurück zum Zitat Brawarsky P, Brooks DR, Mucci LA, Wood PA (2004) Effect of physician recommendation and patient adherence on rates of colorectal cancer testing. Cancer Detect Prev 28: 260–268PubMedCrossRef Brawarsky P, Brooks DR, Mucci LA, Wood PA (2004) Effect of physician recommendation and patient adherence on rates of colorectal cancer testing. Cancer Detect Prev 28: 260–268PubMedCrossRef
4.
Zurück zum Zitat Breen N, Wagener DK, Brown ML, Davis WW, Ballard-Barbash R (2001) Progress in cancer screening over a decade: results of cancer screening from the 1987, 1992, and 1998 National Health Interview Surveys. J Natl Cancer Inst 93: 1704–1713PubMedCrossRef Breen N, Wagener DK, Brown ML, Davis WW, Ballard-Barbash R (2001) Progress in cancer screening over a decade: results of cancer screening from the 1987, 1992, and 1998 National Health Interview Surveys. J Natl Cancer Inst 93: 1704–1713PubMedCrossRef
5.
Zurück zum Zitat Brenes GA, Paskett ED (2000) Predictors of stage of adoption for colorectal cancer screening. Prev Med 31: 410–416PubMedCrossRef Brenes GA, Paskett ED (2000) Predictors of stage of adoption for colorectal cancer screening. Prev Med 31: 410–416PubMedCrossRef
6.
Zurück zum Zitat Cucino C, Buchner AM, Sonnenberg A (2002) Continued rightward shift of colorectal cancer. Dis Colon Rectum 45: 1035–1040PubMedCrossRef Cucino C, Buchner AM, Sonnenberg A (2002) Continued rightward shift of colorectal cancer. Dis Colon Rectum 45: 1035–1040PubMedCrossRef
7.
Zurück zum Zitat Dolan NC, Ferreira MR, Davis TC, Fitzgibbon ML, Rademaker A, Liu D, Schmitt BP, Gorby N, Wold M, Bennett CL (2004) Colorectal cancer screening knowledge, attitudes, and beliefs among veterans: does literacy make a difference? J Clin Oncol 22: 2617–2622PubMedCrossRef Dolan NC, Ferreira MR, Davis TC, Fitzgibbon ML, Rademaker A, Liu D, Schmitt BP, Gorby N, Wold M, Bennett CL (2004) Colorectal cancer screening knowledge, attitudes, and beliefs among veterans: does literacy make a difference? J Clin Oncol 22: 2617–2622PubMedCrossRef
8.
Zurück zum Zitat Fleming ID, Cooper JS, Hensen DE, Hutter RV, Kennedy BJ, Murphy GP, et al. (1997) American Joint Commission on Cancer (AJCC) Staging Manual, Fifth Ed. Philadelphia: Lippincott-Raven Fleming ID, Cooper JS, Hensen DE, Hutter RV, Kennedy BJ, Murphy GP, et al. (1997) American Joint Commission on Cancer (AJCC) Staging Manual, Fifth Ed. Philadelphia: Lippincott-Raven
9.
Zurück zum Zitat Frazier AL, Colditz GA, Fuchs CS, Kuntz KM (2000) Cost-effectiveness of screening for colorectal cancer in the general population. JAMA 284: 1954–1961PubMedCrossRef Frazier AL, Colditz GA, Fuchs CS, Kuntz KM (2000) Cost-effectiveness of screening for colorectal cancer in the general population. JAMA 284: 1954–1961PubMedCrossRef
10.
Zurück zum Zitat Gupta AK, Melton LJ, Petersen GM, Timmons L, Vege S, Harmsen W, Diehl N, Zinsmeister A, Ahlquist D (2005) Changing trends in the incidence, stage, survival, and screen-detection of colorectal cancer: A population-based study. Clin Gastroenterol Hepatol 3: 150–158PubMedCrossRef Gupta AK, Melton LJ, Petersen GM, Timmons L, Vege S, Harmsen W, Diehl N, Zinsmeister A, Ahlquist D (2005) Changing trends in the incidence, stage, survival, and screen-detection of colorectal cancer: A population-based study. Clin Gastroenterol Hepatol 3: 150–158PubMedCrossRef
11.
Zurück zum Zitat Hardcastle JD, Chamberlain JO, Robinson MH, Moss SM, Amar SS, Balfour TW, James PD, Mangham CM (1996) Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet 348: 1472–1477PubMedCrossRef Hardcastle JD, Chamberlain JO, Robinson MH, Moss SM, Amar SS, Balfour TW, James PD, Mangham CM (1996) Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet 348: 1472–1477PubMedCrossRef
12.
Zurück zum Zitat Holt WS Jr (1991) Factors affecting compliance with screening sigmoidoscopy. J Fam Pract 32: 585–589PubMed Holt WS Jr (1991) Factors affecting compliance with screening sigmoidoscopy. J Fam Pract 32: 585–589PubMed
13.
Zurück zum Zitat Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, Feuer EJ, Thun MJ (2005) Cancer statistics, 2005. CA Cancer J Clin 55: 10–30PubMed Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, Feuer EJ, Thun MJ (2005) Cancer statistics, 2005. CA Cancer J Clin 55: 10–30PubMed
14.
Zurück zum Zitat Jha AK, Perlin JB, Kizer KW, Dudley RA (2003) Effect of the transformation of the Veterans Affairs Health Care System on the quality of care. N Engl J Med 348: 2218–2227PubMedCrossRef Jha AK, Perlin JB, Kizer KW, Dudley RA (2003) Effect of the transformation of the Veterans Affairs Health Care System on the quality of care. N Engl J Med 348: 2218–2227PubMedCrossRef
15.
Zurück zum Zitat Kerr EA, Gerzoff RB, Krein SL, Selby JV, Piette JD, Curb JD, Herman WH, Marrero DG, Narayan KMV, Safford MM, Thompson T, Mangione CM (2004) Diabetes care quality in the Veterans Affairs Health Care System and commercial managed care: the TRIAD study. Ann Intern Med 141: 272–281PubMed Kerr EA, Gerzoff RB, Krein SL, Selby JV, Piette JD, Curb JD, Herman WH, Marrero DG, Narayan KMV, Safford MM, Thompson T, Mangione CM (2004) Diabetes care quality in the Veterans Affairs Health Care System and commercial managed care: the TRIAD study. Ann Intern Med 141: 272–281PubMed
16.
Zurück zum Zitat Lewis SF, Jensen NM (1996) Screening sigmoidoscopy. Factors associated with utilization. J Gen Intern Med 11: 542–544PubMedCrossRef Lewis SF, Jensen NM (1996) Screening sigmoidoscopy. Factors associated with utilization. J Gen Intern Med 11: 542–544PubMedCrossRef
17.
Zurück zum Zitat Mandel JS, Bond JH, Church TR, Snover DC, Bradley GM, Schuman LM, Ederer F (1993) Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med 328: 1365–1371PubMedCrossRef Mandel JS, Bond JH, Church TR, Snover DC, Bradley GM, Schuman LM, Ederer F (1993) Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med 328: 1365–1371PubMedCrossRef
18.
Zurück zum Zitat Manne S, Markowitz A, Winawer S, Meropol NJ, Haller D, Rakowski W, Babb J, Jandorf L (2002) Correlates of colorectal cancer screening compliance and stage of adoption among siblings of individuals with early onset colorectal cancer. Health Psychol 21: 3–15PubMedCrossRef Manne S, Markowitz A, Winawer S, Meropol NJ, Haller D, Rakowski W, Babb J, Jandorf L (2002) Correlates of colorectal cancer screening compliance and stage of adoption among siblings of individuals with early onset colorectal cancer. Health Psychol 21: 3–15PubMedCrossRef
19.
Zurück zum Zitat Mostafa G, Matthews BD, Norton HJ, Kercher KW, Sing RF, Heniford BT (2004) Influence of demographics on colorectal cancer. Am Surg 70: 259–264PubMed Mostafa G, Matthews BD, Norton HJ, Kercher KW, Sing RF, Heniford BT (2004) Influence of demographics on colorectal cancer. Am Surg 70: 259–264PubMed
20.
Zurück zum Zitat Pignone M, Saha S, Hoerger T, Mandelblatt J (2002) Cost-effectiveness analyses of colorectal cancer screening: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 137: 96–104PubMed Pignone M, Saha S, Hoerger T, Mandelblatt J (2002) Cost-effectiveness analyses of colorectal cancer screening: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 137: 96–104PubMed
23.
Zurück zum Zitat Rabeneck L, Davila JA, El-Serag HB (2003) Is there a true “shift” to the right colon in the incidence of colorectal cancer? Am J Gastroenterol 98: 1400–1409PubMed Rabeneck L, Davila JA, El-Serag HB (2003) Is there a true “shift” to the right colon in the incidence of colorectal cancer? Am J Gastroenterol 98: 1400–1409PubMed
24.
Zurück zum Zitat Ramsey SD, Mandelson MT, Berry K, Etzioni R, Harrison R (2003) Cancer-attributable costs of diagnosis and care for persons with screen-detected versus symptom-detected colorectal cancer. Gastroenterology 125: 1645–1650PubMedCrossRef Ramsey SD, Mandelson MT, Berry K, Etzioni R, Harrison R (2003) Cancer-attributable costs of diagnosis and care for persons with screen-detected versus symptom-detected colorectal cancer. Gastroenterology 125: 1645–1650PubMedCrossRef
25.
Zurück zum Zitat Seeff LC, Nadel MR, Blackman D (2003) Colorectal cancer test use among persons aged >50 years—United States. Morb Mortal Wkly Rep 52: 193–196 Seeff LC, Nadel MR, Blackman D (2003) Colorectal cancer test use among persons aged >50 years—United States. Morb Mortal Wkly Rep 52: 193–196
26.
Zurück zum Zitat Seeff LC, Nadel MR, Klabunde CN, Thompson T, Shapiro JA, Vernon SW, Coates RJ (2004) Patterns and predictors of colorectal cancer test use in the adult U.S. population. Cancer 100: 2093–2103PubMedCrossRef Seeff LC, Nadel MR, Klabunde CN, Thompson T, Shapiro JA, Vernon SW, Coates RJ (2004) Patterns and predictors of colorectal cancer test use in the adult U.S. population. Cancer 100: 2093–2103PubMedCrossRef
27.
Zurück zum Zitat Selby JV, Friedman GD, Quesenberry CP Jr, Weiss NS (1992) A case-control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med 326: 653–657PubMedCrossRef Selby JV, Friedman GD, Quesenberry CP Jr, Weiss NS (1992) A case-control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med 326: 653–657PubMedCrossRef
28.
Zurück zum Zitat Smith RA, von Eschenbach AC, Wender R (for the ACS Cancer Advisory Committee) (2001) American Cancer Society guidelines for the early detection of cancer: Update of early detection guidelines for prostate, colorectal, and endometrial cancers. CA Cancer J Clin 51: 38–75PubMedCrossRef Smith RA, von Eschenbach AC, Wender R (for the ACS Cancer Advisory Committee) (2001) American Cancer Society guidelines for the early detection of cancer: Update of early detection guidelines for prostate, colorectal, and endometrial cancers. CA Cancer J Clin 51: 38–75PubMedCrossRef
29.
Zurück zum Zitat VHA Performance Measurement Data: EPRP Reports. Office of Quality, Performance, Veterans Health Administration, Department of Veterans Affairs 1999–2003 VHA Performance Measurement Data: EPRP Reports. Office of Quality, Performance, Veterans Health Administration, Department of Veterans Affairs 1999–2003
30.
Zurück zum Zitat Walter LC, Davidowitz NP, Heineken PA, Covinsky KE (2004) Pitfalls of converting practice guidelines into quality measures: lessons learned from a VA performance measure. JAMA 291: 2466–2470PubMedCrossRef Walter LC, Davidowitz NP, Heineken PA, Covinsky KE (2004) Pitfalls of converting practice guidelines into quality measures: lessons learned from a VA performance measure. JAMA 291: 2466–2470PubMedCrossRef
31.
Zurück zum Zitat Winawer SJ (2001) A quarter century of colorectal cancer screening: progress and prospects. J Clin Oncol 19: 6S–12SPubMed Winawer SJ (2001) A quarter century of colorectal cancer screening: progress and prospects. J Clin Oncol 19: 6S–12SPubMed
32.
Zurück zum Zitat Winawer S, Fletcher R, Rex D, Bond J, Burt R, Ferrucci J, Ganiats T, Levin T, Woolf S, Johnson D, Kirk L, Litin S, Simmang C, Gastrointestinal Consortium Panel (2003) Colorectal cancer screening and surveillance: clinical guidelines and rationale—Update based on new evidence. Gastroenterology 124: 544–560PubMedCrossRef Winawer S, Fletcher R, Rex D, Bond J, Burt R, Ferrucci J, Ganiats T, Levin T, Woolf S, Johnson D, Kirk L, Litin S, Simmang C, Gastrointestinal Consortium Panel (2003) Colorectal cancer screening and surveillance: clinical guidelines and rationale—Update based on new evidence. Gastroenterology 124: 544–560PubMedCrossRef
33.
Zurück zum Zitat Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, Waye JD, Schapiro M, Bond JH, Panish JF, Ackroyd F, Shike M, Kurtz RC, Hornsby-Lewis L, Gerdes H, Stewart ET, The National Poly Study Workgroup (1993) Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med 329: 1977–1981PubMedCrossRef Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, Waye JD, Schapiro M, Bond JH, Panish JF, Ackroyd F, Shike M, Kurtz RC, Hornsby-Lewis L, Gerdes H, Stewart ET, The National Poly Study Workgroup (1993) Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med 329: 1977–1981PubMedCrossRef
34.
Zurück zum Zitat Zapka JG, Puleo E, Vickers-Lahti M, Luckmann R (2002) Healthcare system factors and colorectal cancer screening. Am J Prev Med 23: 28–35PubMedCrossRef Zapka JG, Puleo E, Vickers-Lahti M, Luckmann R (2002) Healthcare system factors and colorectal cancer screening. Am J Prev Med 23: 28–35PubMedCrossRef
Metadaten
Titel
Care within a Veterans Hospital
Earlier detection of colon cancer
verfasst von
P. van Roessel
R. V. Rouse
S. M. Wren
Publikationsdatum
01.08.2007
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 8/2007
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-006-9184-6

Weitere Artikel der Ausgabe 8/2007

Surgical Endoscopy 8/2007 Zur Ausgabe

News and Notices

News and Notices

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Recycling im OP – möglich, aber teuer

05.05.2024 DCK 2024 Kongressbericht

Auch wenn sich Krankenhäuser nachhaltig und grün geben – sie tragen aktuell erheblich zu den CO2-Emissionen bei und produzieren jede Menge Müll. Ein Pilotprojekt aus Bonn zeigt, dass viele Op.-Abfälle wiederverwertet werden können.

Im OP der Zukunft läuft nichts mehr ohne Kollege Roboter

04.05.2024 DCK 2024 Kongressbericht

Der OP in der Zukunft wird mit weniger Personal auskommen – nicht, weil die Technik das medizinische Fachpersonal verdrängt, sondern weil der Personalmangel es nötig macht.

Nur selten Nachblutungen nach Abszesstonsillektomie

03.05.2024 Tonsillektomie Nachrichten

In einer Metaanalyse von 18 Studien war die Rate von Nachblutungen nach einer Abszesstonsillektomie mit weniger als 7% recht niedrig. Nur rund 2% der Behandelten mussten nachoperiert werden. Die Therapie scheint damit recht sicher zu sein.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.