The effect of colorectal cancer screening on health status in a survey study

Abstract

Background: Colorectal cancer (CRC) screening has been found to reduce mortality from CRC but it may have adverse effects on other aspects of health. Our aim was to evaluate the effect of CRC screening on overall health status among men and women within a randomized health-services study in Finland.

Material and methods: A random sample of 10,648 men and women born in 1951 received a questionnaire on health and lifestyle. They were randomized for CRC screening or controls (1:1) in 2011 (N = 10,271). The current study population consisted of those who responded to the questionnaire both before and after screening (n = 4895). Self-rated health (SRH), perceived healthiness of diet and perceived physical fitness were used to determine health status, and assessed with logistic and ordered logistic models using calendar time (2010, 2012), screening randomization and demographic characteristics as covariates.

Results: SRH, healthiness of diet and physical fitness improved over time (OR 1.32, CI 1.17–1.48, OR 1.23, CI 1.08–1.41 and OR 1.44, CI 1.28–1.60, respectively). Compared to non-invited controls, CRC screening invitation had no effect on these measures (OR 0.91, CI 0.74–1.12, OR 0.95, CI 0.75–1.20, and OR 1.09, CI 0.87–1.37, respectively). Women reported better health status than men. However, among those who attended screening, women reported weaker, and men better health status than the respective controls.

Conclusions: CRC screening did not have any effect on health status measured using self-rated health, healthiness of diet, and physical fitness. Thus, screening for colorectal cancer can be recommended as a health policy.