The prevalence of CRC is approximately 5% (1,3). Although over 80% of cases are sporadic (the remaining result from inflammatory bowel disease and hereditary colon cancer syndromes), many veterans have one or more risk factors for CRC including advancing age, smoking, heavy alcohol intake, high fat low fiber diet, sedentary lifestyle, and obesity. As the veteran population ages, preventative services will continue to be an important part of their health care. As the US population is aging, so too is the US veteran population. This is further complicated by the fact that a recent study that examined the self-rated health and functioning of a national sample of veterans aged 65 or older reported that over one-half of elderly veterans report difficulty in functioning and rated their health status as fair or poor (14). This group of veterans may also live alone, may not have easy access to transportation to and from a health facility and may find it physically challenging to prepare their colon with cleansing agents for a good exam during a colonoscopy. Age and comorbidity also affect the survival rates after resection of colorectal cancer. A study by Ko et al used nationwide data from the healthcare cost and utilization program and calculated mortality among 22,000 resections for colon cancer15. They found that besides the volume of surgery, two other factors that affect post colon cancer mortality are age and comorbid disease (i.e. cardiovascular, pulmonary and liver diseases) (p<0.05). Another study of 80 patients (16), 80 years and older, showed a postoperative mortality rate of 8% and 5yr survival of only 23%. Only 13 patients lived longer than 5 years. Many elderly people may need a coronary revascularization procedure before planned surgery, if a colon cancer is discovered. Older age has been associated with adverse outcomes in patients undergoing percutaneous coronary intervention. A study by the National Heart, Lung and Blood Institute included 4620 PCI treated patients and reported adjusted relative risks in elderly (>80 years) compared to younger (<65 years) patients to be higher for inhospital related death (3.64 versus 1.0) as well as myocardial infarction (2.57 versus 1.0) (17).