Impact of a colonoscopic screening examination for colorectal cancer on later utilization of distal GI endoscopies.

BACKGROUND

Colonoscopic screening for colorectal cancer is being implemented in an increasing number of countries. This might lead to a demand for colonoscopies that could outstrip supply.

OBJECTIVE

We wanted to investigate whether undergoing a colonoscopic examination for colorectal cancer would affect the utilization of later distal GI endoscopies for other indications than follow-up of the findings at the screening examination (usual-care endoscopies).

DESIGN

Prospective case control study.

PATIENTS

In 1996, a screening group of 634 individuals, aged 63 to 72 years, randomly drawn from the official population registry, was invited to a "once only" colonoscopic screening examination for colorectal cancer. A total of 451 individuals (71%) attended. An age- and sex-matched control group of 634 individuals was enrolled from the same registry. Both groups belonged to the encatchment area of a single hospital.

MAIN OUTCOME MEASUREMENTS

Distal endoscopies performed in the 2 groups from January 1996 to November 2004 were registered by investigating medical records.

RESULTS

A total of 1268 individuals (52.4% women) were followed for 9 years. Sixty-three individuals (9.9%) in the screening group and 110 (17.4%) individuals in the control group (odds ratio 0.53, 95% confidence interval 0.38-0.73) had had a total of 85 and 169 usual-care distal endoscopies, respectively (P < .001).

CONCLUSIONS

Undergoing a colonoscopic examination for colorectal cancer seems to reduce the utilization of later usual-care endoscopic examinations. This finding could have an impact on the estimation of endoscopic resources needed for colorectal cancer screening.