title: Care within a veterans hospital: earlier detection of colon cancer.
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 < or = .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.
authors.affiliation: Stanford University School of Medicine, Stanford University, Palo Alto, California 94305, United States.
authors.forename: P
authors.initials: P
authors.lastname: van Roessel
authors.forename: R V
authors.initials: RV
authors.lastname: Rouse
authors.forename: S M
authors.initials: SM
authors.lastname: Wren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality; D042241:Early Diagnosis; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014481:United States