Colon cancer is the second most common cause of cancer death in the United States. There is good evidence that screening for colon cancer reduces the risk of dying from colon cancer. But because there are multiple ways to screen for colon cancer, patients face the challenging question of how to be screened.
In the United States, the most commonly used approaches are:
Colonoscopy: an examination of the colon using a lighted tube with a video camera at the end. The examination is performed in the hospital or doctor’s office after a bowel preparation at home.
Fecal immunochemical testing (FIT): a stool test kit (looking for blood in the stool) that is performed at home.
While we know that both tests work, we don’t know if one is better than the other.
With funding and support of the VA Cooperative Study program, researchers are running a randomized trial of colonoscopy vs. home FIT testing to determine which approach is better able to lower the death rate from colon cancer. The participants are male and female veterans age 50 to 75 who are at average risk for colon cancer.
Because most are not destined to develop colon cancer (much less die from it), this trial requires many participants. Nearly 50,000 veterans have been randomized at one of 45 VA Medical Centers across the United States. The study, which is co-chaired by Dartmouth Institute Associate Professor Douglas Robertson, will not be completed until 2028.