Healthcare Inspection – Colorectal Cancer Screening Practices, Charlie Norwood VA Medical Center, Augusta, Georgia

OIG conducted a review to assess the merit of allegations involving colorectal cancer (CRC) screening practices at the Charlie Norwood VA Medical Center (facility) in Augusta, GA. We substantiated that patients over the age of 50 were only being scheduled for preventative [screening] colonoscopies if blood was detected in their stools; however, we did not substantiate the implied inappropriateness of this process for patients with average risk for developing CRC. Veterans Health Administration (VHA) and the Centers for Disease Control and Prevention (CDC) have identified several effective CRC screening methods, including a fecal occult blood test, for patients at average risk. However, we found that facility staff did not fully comply with VHA guidelines on shared decision-making for patients who preferred screening colonoscopies rather than fecal occult blood tests. Facility managers have since revised the screening colonoscopy consult process. However, facility providers did not have a common understanding about the current local process for requesting screening colonoscopies for average risk patients. We did not substantiate the allegation that patients have been diagnosed with CRC because they did not receive appropriate preventative [screening] colonoscopies. We found that, in general, the patients included in our sample received fecal occult blood tests in accordance with VHA and Veterans Integrated Service Network 7 guidance and CDC guidelines. We made two recommendations.