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Colonoscopies performed by specially trained nurses as part of the Swedish bowel cancer screening program are of at least the same quality as those performed by doctors, according to a study from Karolinska Institutet published in the journal Endoscopy. The results suggest that nurses could help to address the increasing demand for examinations within the national screening program.

Colorectal cancer is one of the most common forms of cancer in Sweden. For the past few years, there has been a national screening program aimed at people aged between 60 and 74. Those who receive a positive result from a stool test are offered a follow-up colonoscopy to examine the inside of the bowel.

"As more and more people are offered bowel cancer screening, there is a greater need for endoscopists," says Anna Forsberg, consultant at the Endoscopy Centre, Capio St Göran's Hospital, and docent at the Department of Medicine, Solna, Karolinska Institutet. "Our results show that specially trained nurses can perform colonoscopies to a high standard and help to meet the increased demand."

The researchers analyzed data from the national quality register SveReKKS. The study included a total of nearly 28,000 colonoscopies performed between April 2019 and August 2025. Of these, 42% were carried out by nurses and 58% by doctors. The study included 55 nurses and 170 doctors.

An important international measure of quality is how often an endoscopist detects adenomas (polyps that can develop into cancer).

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