Colonoscopy screening could prevent bowel cancer in nearly 99 000 German patients

By the end of this year, colonoscopy screening will have prevented bowel cancer in approximately 99 000 people since it was introduced in Germany. This is the result obtained by Hermann Brenner of the German Cancer Research Center in Heidelberg and his co-authors in their interim assessment conducted eight years after the procedure was added to the German cancer screening program. The authors present their projection and initial results of colonoscopy screening in Germany in the current edition of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2010: 107(43): 753‑9). The article was accompanied by an editorial on the subject written by Stefanie Klug of the Dresden University of Technology (Dtsch Arztebl Int 2010; 107(43): 751‑2).

On the basis of German registry data, Brenner et al. determined the rates of participation in screening and the prevalence of advanced adenomas and carcinomas detected early, for each year from 2003 to 2008. Their projections for 2009 and 2010 were based on the values recorded for 2008.

The study showed that advanced adenomas had been identified and removed in more than 300 000 screening participants in the first eight years of the screening colonoscopy program. The projections showed that this had prevented approximately 99 000 cases of bowel cancer. If they had not been removed, these advanced adenomas would have become clinically manifest a median of 10 years after screening colonoscopy. Over the same period, approximately 50 000 colorectal carcinomas were detected early as a result of screening colonoscopy, mostly still at a curable stage.

In the authors' view, still more cases would be prevented if the participation rate could be improved, using targeted invitations for example.

Screening colonoscopy has been offered as part of cancer screening in Germany since October 2002. It is available to men and women aged 55 and older.