The impact of colorectal cancer screening on healthcare use: A prospective cohort study with quasi-randomised screening invitation.

[OBJECTIVES] This study examines the association between participation in colorectal cancer screening and subsequent secondary healthcare use.

[STUDY DESIGN] A prospective cohort study.

[METHODS] Exposure was based on a quasi-randomised screening implementation, with a 24-month follow-up. Outcomes included out-of-hospital specialist visits, hospitalisation, outpatient clinic visits, emergency room visits, colonoscopies and sigmoidoscopies, and prescription drugs. We employed a two-step model to estimate the relative risk and incidence-rate ratio of healthcare use, adjusted for baseline healthcare usage over the past decade and relevant socioeconomic factors. The results were stratified by screening results.

[RESULTS] Individuals with negative screenings were more likely to consult out-of-hospital specialists compared with a screening-naive control group. All screening groups had higher risk of hospitalisation, higher risk of using outpatient and emergency services, and higher risk of redeeming prescription drugs compared with the control group. Among those that used the respective services, it did not seem that screening groups had more visits or uses compared with the control group.

[CONCLUSIONS] We observed an increase in healthcare use following colorectal cancer screening, suggesting that screening participants are referred more to secondary healthcare services.