Mortality and Rate of Hospitalization in a Colonoscopy Screening Program From a Randomized Health Services Study

Area of Science:

• Gastroenterology
• Public Health
• Preventive Medicine

Background:

• Quantifying adverse events from screening colonoscopy is challenging due to a lack of robust comparison groups.
• The Polish Colonoscopy Screening Program (PCSP) offers a unique opportunity to evaluate colonoscopy safety.
• This study addresses the need for valid data on colonoscopy-related adverse events.

Purpose of the Study:

• To compare mortality and unplanned hospitalization rates between individuals undergoing screening colonoscopy and a matched unscreened control group.
• To assess the safety of screening colonoscopy within a national screening program.
• To provide evidence-based insights into the risks associated with colonoscopy screening.

Main Methods:

• A 1:1 matched cohort study design involving individuals aged 55-64 in the PCSP (2012-2015).
• Comparison of mortality and hospitalization data from national registries between the screening and control groups.
• Analysis of hospitalizations categorized as related or unrelated to colonoscopy based on ICD codes.

Main Results:

• No significant difference in overall mortality between the screening and control groups (0.22% vs 0.22%).
• A statistically significant increase in overall unplanned hospitalizations in the screening group (2.39% vs 2.31%), primarily driven by post-procedure events.
• An increased rate of hospitalizations assessed as related to colonoscopy in the screening group (0.24% vs 0.22%).

Conclusions:

• Screening colonoscopy, as implemented in the PCSP, does not elevate mortality risk.
• A small but significant increase in unplanned hospitalizations is associated with screening colonoscopy.
• Further research and monitoring are warranted to understand and mitigate post-colonoscopy adverse events.