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Cancer research

Veterans Health Study Reveals Inaccurate CRC Screening Measure in Minority of Patients

Strategic Insights

— 2 min read

A recent study published in the August 2025 edition of Medicine has shed light on the issue of colorectal cancer (CRC) screening within the Veterans Health Administration (VA). The research, conducted by a team of scientists from New York University (NYU), aimed to examine the predictors of CRC and the accuracy of the conventional definition of up-to-date screening in the VA population.

According to the study, which analyzed data from 2012 to 2018, the VA has reported a higher CRC screening uptake compared to the US general population. However, CRC remains a prevalent cancer within the VA system. The researchers classified patients into five categories based on their screening status and risk factors, and found that Category 4 and Category 5 patients had a higher risk of CRC compared to Category 1 patients. Additionally, the study found that Black patients, diabetes, and alcohol use disorder were associated with a higher risk of CRC.

Key Takeaways:

  • The conventional definition of up-to-date CRC screening does not accurately reflect screening status in an important minority of CRC patients.
  • Category 4 and Category 5 patients, who were classified as being up-to-date or not up-to-date average-risk patients aged 75, had a higher risk of CRC compared to Category 1 patients.
  • Black patients, diabetes, and alcohol use disorder were associated with a higher risk of CRC.
  • The study's findings highlight the need for a more nuanced approach to CRC screening, taking into account individual risk factors and screening status.
  • The VA's CRC screening program aims to improve health outcomes for veterans, but the study's results suggest that more work is needed to ensure that all eligible patients receive appropriate screening.

Statistics:

  • 3714 CRC cases were identified in the study population.
  • 12.5% of CRC cases occurred in individuals outside of the 50-75 age range or with high-risk personal or family history.
  • Category 4 patients had an odds ratio (OR) of 1.40 (95% CI 1.11-1.78) for CRC compared to Category 1 patients.
  • Category 5 patients had an OR of 6.23 (95% CI 5.06-7.66) for CRC compared to Category 1 patients.
  • Black patients had an OR of 1.54 (95% CI 1.37-1.73) for CRC compared to White patients.

Sources:

  • Conventional Screening Measure Does Not Accurately Capture Screening Status In a Minority of Patients With Colorectal Cancer. Medicine, 2025;104(29).
  • National Institutes of Health (NIH) - USA
  • AGA Caroline Craig Augustyn & Damian Augustyn Award in Digestive Cancer
  • Freenome
  • Lippincott Williams & Wilkins
  • Elsevier
  • New York University (NYU) Grossman Sch Med, Dept. of Population Health
  • Peter S. Liang
  • Taylor M. McCready
  • Yingzhi Qian
  • Simona C. Kwon
  • Scott E. Sherman
  • Shinjini Nandi
  • Shawn Wen
  • Ann G. Zauber
  • Jason A. Dominitz

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