Compliance and findings in a Swedish population screened for colorectal cancer with sigmoidoscopy.
OBJECTIVE
The aim of this study was to evaluate the patterns of compliance and the frequency of adenomas and neoplasms in a Swedish population.


METHODS
In 1996, 2000 men and women born in 1935 or 1936 were selected at random from the population registers of Uppsala and Malmö/Lund. All subjects were invited by mail to participate. In a randomised study design, subjects were either called up by a nurse to schedule the appointment for sigmoidoscopy or instructed to call themselves. At sigmoidoscopy subjects with a cancer, an adenoma (neoplastic polyp) or more than three hyperplastic polyps were scheduled for a complete colonoscopy.


RESULTS
Thirty-nine percent (770/1988) of all the invited subjects had a sigmoidoscopy. The participation differed between the two centres, 47% at the Uppsala centre and 30% at the Malmö/Lund centre (P<0.01). There was no statistically significant difference between the two different invitation groups. In all, 98 subjects (13%) were planned for colonoscopy. Thirty-one (35%) of the subjects having a colonoscopy were women and 57 (65%) were men. Fifty-five true adenomas were found in 46 subjects. All together, six subjects had proximal adenomas. Five adenocarcinomas were diagnosed, all within the reach of the sigmoidoscope.


CONCLUSIONS
The compliance was lower and the adenomas were fewer than expected. To increase compliance it is necessary with rigorously controlled invitation routines.
Blom
J
J
Department of Surgery at University Hospital South Hospital, Stockholm, Sweden. johannes.blom@kirurg.sos.sll.se
Lidén
A
A
Jeppsson
B
B
Holmberg
L
L
Påhlman
L
L
D000236:Adenoma / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control*; D017677:Age Distribution; D003111:Colonic Polyps / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011336:Probability; D012307:Risk Factors; D017678:Sex Distribution; D012812:Sigmoidoscopy / Q000379:methods; D013548:Sweden / Q000453:epidemiology