Reduced risk of emergency admission for colorectal cancer associated with the introduction of bowel cancer screening across England: a retrospective national cohort study



Geraghty, J, Shawihdi, M, Devonport, E, Sarkar, S, Pearson, MG and Bodger, K ORCID: 0000-0002-1825-3239
(2018) Reduced risk of emergency admission for colorectal cancer associated with the introduction of bowel cancer screening across England: a retrospective national cohort study. COLORECTAL DISEASE, 20 (2). 94 - 104.

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Abstract

Aim We wanted to find out if roll‐out of the bowel cancer screening programme (BCSP ) across England was associated with a reduced risk of emergency hospital admission for people presenting with colorectal cancer (CRC ) during this period. Method This is a retrospective cohort study of 27 763 incident cases of CRC over a 1‐year period during the roll‐out of screening across parts of England. The primary outcome was the number of emergency (unplanned) hospital admissions during the diagnostic pathway. The primary exposure was to those living in an area where the BCSP was active at the time of diagnosis. Patients were categorized into three exposure groups: BCSP not active (reference group), BCSP active < 6 months or BCSP active ≥ 6 months. Results The risk of emergency admission for CRC in England was associated with increasing age, female gender, comorbidity and social deprivation. After adjusting for these factors in logistic regression, the odds ratio (OR ) for emergency admission in patients diagnosed ≥ 6 months after the start‐up of local screening was 0.83 (CI 0.76–0.90). The magnitude of risk reduction was greatest for cases of screening age (OR 0.75; CI 0.63–0.90) but this effect was apparent also for cases outside the 60–69‐year age group (OR 0.85; CI 0.77–0.94). Living in an area with active BCSP conferred no reduction in risk of emergency admission for people diagnosed with oesophagogastric cancer during the same period. Conclusion The start‐up of bowel cancer screening in England was associated with a substantial reduction in the risk of emergency admission for CRC in people of all ages. This suggests that the roll‐out of the programme had indirect benefits beyond those related directly to participation in screening.

Item Type: Article
Uncontrolled Keywords: Colon cancer, emergency admission, bowel cancer screening programme
Depositing User: Symplectic Admin
Date Deposited: 25 Mar 2020 12:01
Last Modified: 05 Jul 2021 20:12
DOI: 10.1111/codi.13822
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3080231