Sociodemographic changes in the population frequency of colonoscopy following the implementation of organised bowel cancer screening: An analysis of data from Swedish registers, 2006–2015

OBJECTIVE: To assess sociodemographic changes in the population frequency of colonoscopy (PFC; number of colonoscopies per 1000 inhabitants per year) among people aged 50–74 in relation to the implementation of a regional colorectal cancer screening programme for people aged 60–69 in the Stockholm-Gotland region (RSG) in 2008. METHOD: The PFC was estimated by year (2006–2015), pre- and post-implementation of colorectal cancer screening programme (2006–2007 vs. 2014–2015), age, sex, residential region, immigrant status and educational level. The data were obtained from Swedish patient and population registers. RESULTS: The PFC largely increased during 2006–2015 in all six Swedish regions. The estimated increase in the pre- vs. post period PFC (ΔPFC) within the RSG was (i) greater for men than for women (5.8 vs. 4.5) and (ii) smaller for people aged 70–74 than for those aged 60–69 (5.5 vs. 9.0), while the corresponding ΔPFCs within each of the other regions were (i) not greater, or even smaller, for men and (ii) not smaller, or even larger, for elderly people aged 70–74. CONCLUSION: A regional implementation of an organised colorectal cancer screening programme did not lead to a higher PFC increase in the screening relevant age group 50–74 years. Nevertheless, changes in the PFC were more pronounced for men and less pronounced for people aged 70–74 than those invited to participate in the screening programme (60–69 years), as compared with the rest of Sweden (without organised colorectal cancer screening).