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Screening colonoscopy improves prevention, early detection of colorectal cancer in Germany
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Screening colonoscopy has significantly improved prevention and early detection of colorectal cancers in Germany since it was introduced in October 2002, according to a 10-year analysis.
“Our analysis underlines the large potential of screening colonoscopy for prevention and early detection of [colorectal cancer] that can be achieved at low risk of overdiagnosis, even at advanced ages,” the researchers wrote.
Aiming to perform a comprehensive analysis of prevented, early detected and overdiagnosed colorectal cancers attributed to the first 10 years of the German screening colonoscopy program, researchers analyzed national registry data on 4,407,971 first-time screening colonoscopies performed on individuals aged at least 55 years from 2003 to 2012. Estimates were made using Markov models with parameters including age- and sex-specific colonoscopy findings, mortality, transitions from nonadvanced to advanced adenoma to preclinical cancer to clinically manifest cancer, and protection from screening colonoscopy.
Overall, the researchers found that the screening program prevented an estimated 180,000 colorectal cancers corresponding to one prevented colorectal cancer per 28 screening colonoscopies. A slight majority of prevented colorectal cancers were among men, and 97% were in patients aged up to 75 years. Furthermore, more than 40,000 colorectal cancers corresponding to one per 121 screening colonoscopies were detected earlier than they would have been without screening, primarily in patients aged up to 75 years (89%). Overdiagnoses were estimated to be slightly more than 4,500 cases, corresponding to one per 1,089 screening colonoscopies, 70% of which were in men and 58% of which were in individuals older than 70 years.
“Efforts to enhance acceptance of screening colonoscopy should be made with priority, which could further substantially enhance reduction of [colorectal cancer] incidence and subsequently [colorectal cancer] mortality,” the researchers concluded. – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.
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