[Requirement of hospital beds in connection with screening for colorectal cancer. The first 5-years of a randomized population survey].

Colorectal cancer puts a major burden on the hospital resources because of its frequency and demands for extensive surgery. Screening with Hemoccult-II detects the disease at an earlier stage in a number of persons. The possible influence upon length of hospital stay is investigated in a randomised trial of 61,938 persons between 45 and 74 years, 30,970 being invited to screening with Hemoccult-II bianually. The first screening was accomplished in 20,672 persons and 17,284 have completed three screenings from 1985 to 1990. The test was positive in 1%, and further examination (colonoscopy) among these revealed cancer in 74 and adenomas in 248 persons. The whole screening group contained 239 persons with cancer and 380 with adenomas, the figures among controls being 216 and 181, respectively. The excess hospital stay in the screening group was 487 days (7%), the major part being one-day admissions for colonoscopy. The average stay was shorter in the screening group and shortest among those with colorectal neoplasia being detected because of positive Hemoccult-II. Measurements of hospital stay included admissions for diagnosis, treatment and complications as well as recurrence within the first year of diagnosis. In conclusion, the excess use of hospital days introduced by screening was limited in the first five years. This will probably later disappear and become negative because of decreasing numbers of cancers in the screening group. Advanced cancers and admissions for possible colorectal cancer will also be less frequent in the screening group.