Swedish screening study reports higher adenoma detection among nurse endoscopists

An observational study published in Endoscopy evaluated nurse and physician performance in Sweden’s colorectal cancer screening program. Sweden began nationwide screening for people aged 60–74 in 2021. Researchers used the Swedish Quality Register for Colonoscopies and Colorectal Cancer Screening to analyze 27,978 screening colonoscopies performed between April 2019 and August 2025. Comparisons used generalized linear mixed-effects models and covered adenoma detection, cecal and ileal intubation, bowel preparation, sedation use, and complications.

Nurses performed 42% of procedures. Their adenoma detection rate was 57%, compared with 46% for physicians (odds ratio 1.55, 95% CI 1.47–1.62). An adenoma detection rate below 25% was recorded for 3.6% of nurse endoscopists and 11.2% of physicians. Nurses also had higher odds of ileal intubation (odds ratio 1.2, 95% CI 1.1–1.2) and longer withdrawal times.

The findings support nurse endoscopists as a potential resource for expanding screening capacity. However, this observational comparison does not establish that provider type caused the differences. The available abstract does not report comparative complication results, other measured quality outcomes, or details of model adjustment. The findings therefore should not be interpreted as demonstrating equivalent safety or improved long-term cancer outcomes.