title: Five-year experience of organized colorectal cancer screening in a Swedish population - increased compliance with age, female gender, and subsequent screening round.
abstract: OBJECTIVE
  To evaluate compliance by age, gender, and screening round in the population based Stockholm/Gotland colorectal cancer screening programme.
  
  
  METHODS
  All individuals aged between 60 and 69 living in the counties of Stockholm and Gotland (Sweden) have, since 2008, successively been included in a colorectal cancer screening programme using biennial faecal occult blood tests (Hemoccult®). Personal invitations including test kits have been sent to home addresses, and individuals with a positive test result have been called to a defined clinic for an assessment colonoscopy. Descriptive statistics have been used to evaluate different aspects of compliance.
  
  
  RESULTS
  Over the five-year period 2008-2012, more than 200,000 individuals from nine different birth cohorts have been invited, with a compliance rate of approximately 60%, which increased by age, female gender, and subsequent screening round. In total, 4,300 individuals (2.1%) with positive tests were referred to assessment colonoscopy, where 213 colorectal cancers were diagnosed. The compliance with the follow-up colonoscopies varied by year, and ranged from 85.6-92.4%.
  
  
  CONCLUSIONS
  The strong organization of the programme contributed to a high compliance rate, that increased by screening round. The lower participation rate among men and among individuals at younger ages needs further attention.
authors: Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden johannes.blom@ki.se.
authors: Johannes
authors: J
authors: Blom
authors: Regional Cancer Centre Stockholm Gotland, Sweden.
authors: Sini
authors: S
authors: Kilpeläinen
authors: Division of Gastroenterology and Hepatology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
authors: Rolf
authors: R
authors: Hultcrantz
authors: Department of Oncology-Pathology, Karolinska Institutet and Regional Cancer Centre Stockholm Gotland, Sweden.
authors: Sven
authors: S
authors: Törnberg
mesh_terms: D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009780:Occult Blood; D010349:Patient Compliance / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology
keywords: FOBT; colorectal; compliance; neoplasm; population; screening