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Low Diagnostic Testing Rates Among Younger Veterans with Iron-Deficiency Anemia and Hematochezia May Contribute to Colorectal Cancer Disparities

A recent study conducted within the Veterans Health Administration (VHA) between 1999 and 2019 revealed concerning findings about diagnostic testing rates and disparities in follow-up for younger veterans with iron-deficiency anemia (IDA) and/or hematochezia. The study, which focused on individuals aged 18 to 49 years, aimed to evaluate the time to diagnostic testing among these patients.

The key findings of the study include:

Low Diagnostic Testing Rates: The study found that diagnostic testing rates for veterans with IDA were 22% at 2 years, and for those with hematochezia, the rate was slightly higher at 40%. This suggests that a significant portion of younger veterans with these symptoms did not undergo recommended diagnostic tests within a reasonable timeframe.

Sex-Based Disparities: Female veterans with IDA were significantly less likely to complete diagnostic testing compared to their male counterparts. This disparity raises questions about why women with IDA may not be receiving the recommended follow-up.

Race and Ethnicity Disparities: The study also highlighted disparities based on race and ethnicity. Black veterans with IDA and Hispanic veterans with IDA and/or hematochezia were less likely to receive diagnostic testing compared to White veterans. These disparities could be a contributing factor to variations in colorectal cancer outcomes among different racial and ethnic groups.

Age and Geographic Region: The likelihood of diagnostic testing completion increased with age, with older veterans being more likely to undergo the recommended tests. The region of care within the VHA also had an impact on diagnostic test completion.

Colorectal cancer is a significant health concern, and early detection and timely diagnostic testing are crucial for improving outcomes. The study’s findings highlight the importance of optimizing diagnostic test follow-up for younger veterans with IDA and hematochezia. By addressing these disparities and improving follow-up rates, it may be possible to enhance early age-onset colorectal cancer-related outcomes and reduce disparities based on sex, race, and ethnicity.

These findings also call for further research to better understand the reasons behind these disparities and to develop interventions that can improve the diagnostic follow-up process for veterans and other individuals at risk of colorectal cancer.

In conclusion, this study sheds light on a critical issue in colorectal cancer diagnosis and underscores the need for more equitable and timely diagnostic testing, especially among younger individuals with iron-deficiency anemia and hematochezia.

Source and credit: JAMA Network Open Journal

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