The impact of screening for colorectal cancer on the future use of colonoscopies

Abstract

BACKGROUND: In Norway colorectal cancer is one of the most common forms of cancer, and is the third cause of cancer mortality (Cancer Registry of Norway, 2008). Norway does not have a national screening program for colorectal cancer and little information exists on the effects and implications such a program will have on the use of healthcare, and on the individuals participating in the screening for colorectal cancer.

OBJECTIVE: The main objective of this thesis is to see how screening for colorectal cancer impacts the future use of colonoscopies, and to investigate if there is an association between the baseline findings on screening and the use of colonoscopies. In addition I will look at the possible effect of socioeconomic variables on the future use of colonoscopies.

METHOD: The method of analysis in this thesis is logistic panel data regression. It is used to analyze the probability of having a future colonoscopy after attending screening.

RESULTS: The main conclusion from this analysis is that baseline findings on screening do have an effect on the future use of colonoscopies; the effect depends on a positive or negative finding. In addition I have found that age, gender, county of residence, income, educational level and marital status to some degree have an effect on the use of colonoscopies.

CONCLUSIONS: From the regression we can see that the hypothesis regarding the effect of findings on screening is confirmed. My analysis suggests that the use of colonoscopies is greater in people that already have attended screening; this should be taken into account when considering implementing a nationwide screening program for colorectal cancer. This because the anticipated costs of such a program may be higher if the screening itself results in higher demand for colonoscopies. The economic effect of this increased use of colonoscopies should be examined before implementing such a program.