Original ArticleClinical EndoscopyImpact of a colonoscopic screening examination for colorectal cancer on later utilization of distal GI endoscopies
Section snippets
Patients and methods
In 1983, 400 individuals, aged 50 to 59 years, were randomly drawn from the official Norwegian population registry of Telemark County and offered a screening examination for CRC by flexible sigmoidoscopy.9 An age- and sex-matched group of controls (n = 399), not being offered screening examination, was also drawn from the same registry. Three hundred twenty-three individuals (81%) attended the screening examination; 76 (19%) refused to attend after 1 postal reminder. A total of 112 (35%) in the
Results
A total of 1268 individuals, 634 in each group, were studied for 9 years. In each group, 332 were women (52.4%). The mean age in the 2 groups at the start of the observation period in 1996 was 67.5 years (range, 63-72 years).
In the screening group, 63 individuals (9.9%), and, in the control group, 110 individuals (17.4%) attended 1 or more usual-care distal endoscopies during the observation period (odds ratio 0.53, 95% confidence interval 0.38-0.73, P < .001). The total number of usual-care
Discussion
Implementing a population-based colonoscopic screening program will inevitably increase the utilization of procedures. One will, however, expect that those who receive colonoscopy screening will have fewer lower-GI investigations over the next few years. This assumption was confirmed in the present study where the screening group had 50% fewer usual-care distal endoscopic examinations than the control group during 9 years after a screening colonoscopy. Such an effect of screening on the
Acknowledgments
We thank Deidi Ann Bergestuen for linguistic revision of the manuscript.
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