Introduction We examined whether roll out of the bowel cancer screening programme (BCSP) across England was associated with a reduced risk of emergency hospital admission for people presenting with colorectal cancer (CRC) during this period.

Methods Design: Retrospective cohort study of 27,763 incident cases of CRC over a 1-year period during the roll-out of screening across parts of England. Primary outcome: Emergency (unplanned) hospital admission during diagnostic pathway. Primary exposure: Living in an area where BCSP was active at the time of diagnosis. Patients were categorised into three exposure groups: BCSP not active (reference group), active <6 months or active ≥6 months. To explore confounding we studied risk of emergency admission for cases of oesophagogastric cancer using the same design.

Results Risk of emergency admission for CRC in England was associated with increasing age, female gender, co-morbidity and social deprivation. After adjusting for these factors in logistic regression, the odds ratio for emergency admission in patients diagnosed ≥6 months after start-up of local screening was 0.83 (CI: 0.76–0.90). The magnitude of risk reduction was greatest for cases of screening age (OR 0.75; CI: 0.63–0.90) but this effect was apparent also for cases outside the 60–69 year age-group (OR 0.85; CI: 0.77–0.94). Living in an area with active BCSP conferred no reduction in risk of emergency admission for people diagnosed with oesophagogastric cancer during the same period.

Conclusion The start-up of bowel cancer screening in England was associated with a substantial reduction in risk of emergency admission for CRC in people of all ages. This suggests that the roll-out of the programme had early and indirect benefits beyond those related directly to participation in screening.

Disclosure of Interest J. Geraghty Grant/research support from: Cook Medical, M. Shawihdi: None Declared, E. Thompson: None Declared, S. Sarkar: None Declared, M. Pearson: None Declared, K. Bodger: None Declared.