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Germany: Colonoscopy prevents 15,000 cancer cases
March 23, 2009Result confirms goals of March's Bowel Cancer Awareness Month
Since 2002, statutory health insurances in Germany have offered an endoscopic examination of the colon (colonoscopy) free of charge for all insured persons from the age of 55. Germany was the first country to make nationwide endoscopic screening for bowel cancer a part of its statutory early cancer detection program.
Scientists headed by Professor Hermann Brenner at DKFZ have now published a first calculation of the number of colorectal cancers prevented between 2003 and 2010 thanks to colonoscopy screening. The results will serve as a decision-making basis for an evidence-based evaluation of the program. Moreover, it is important for each participant to know about the benefits of the examination which is wrongly feared by many as being very unpleasant.
The researchers evaluated all 1.8 million colonoscopies which have been carried out to date in the screening program. As a calculation basis they used the number of discovered and removed advanced precancerous lesions (adenomas) which are highly likely to progress into cancer. The epidemiologists have estimated that participation in screening colonoscopy will prevent about 15,000 cases of colorectal cancer by the year 2010.
About 73.000 new cases of colorectal cancer are diagnosed each year in Germany. Around 40 percent of patients die within five years after diagnosis and another portion of sufferers succumb to the disease in the course of the following years. Therefore, Brenner's research team expects that the colonoscopy program will save around 7,500 lives between the years of 2003 and 2010 thanks to the removal of precancerous lesions alone. Moreover, since colonoscopy examinations detect cancer usually at an early stage when it is still curable, the screening program will prevent even more deaths.
The results obtained are based on complex calculations: The number of advanced adenomas found must calculated against the probability that these cancer precursors turn into cancer within a particular period of time. In addition, the calculation takes account of other factors such as the percentage of screening participants who die of other causes before cancer occurs and the participation rate in the respective age groups.
The investigators calculated the number of cancer cases prevented for each year individually and accumulated the values. Although the number of advanced adenomas discovered remains nearly constant over the years, the rate of cancer cases prevented rises each year, since many of the adenomas discovered and removed would otherwise have become cancerous several years later.
The yearly participation rate in colonoscopy screening has remained almost constant since 2003 at about four percent of eligible women and three percent of eligible men. Participants with inconspicuous examination results are offered a second examination free of charge after ten years. Thus, the total participation rate among those under 70, projected to the ten years between first and second screening colonoscopy, is 40 percent among women and 30 percent among men. "This is not bad for a beginning," says Hermann Brenner, "but if we succeeded in encouraging even more people to participate in the screening program - such as by sending personal invitations to examinations due - many more cancers could be prevented."
Helmholtz Association of German Research Centres
The researchers evaluated all 1.8 million colonoscopies which have been carried out to date in the screening program. As a calculation basis they used the number of discovered and removed advanced precancerous lesions (adenomas) which are highly likely to progress into cancer. The epidemiologists have estimated that participation in screening colonoscopy will prevent about 15,000 cases of colorectal cancer by the year 2010.
About 73.000 new cases of colorectal cancer are diagnosed each year in Germany. Around 40 percent of patients die within five years after diagnosis and another portion of sufferers succumb to the disease in the course of the following years. Therefore, Brenner's research team expects that the colonoscopy program will save around 7,500 lives between the years of 2003 and 2010 thanks to the removal of precancerous lesions alone. Moreover, since colonoscopy examinations detect cancer usually at an early stage when it is still curable, the screening program will prevent even more deaths.
The results obtained are based on complex calculations: The number of advanced adenomas found must calculated against the probability that these cancer precursors turn into cancer within a particular period of time. In addition, the calculation takes account of other factors such as the percentage of screening participants who die of other causes before cancer occurs and the participation rate in the respective age groups.
The investigators calculated the number of cancer cases prevented for each year individually and accumulated the values. Although the number of advanced adenomas discovered remains nearly constant over the years, the rate of cancer cases prevented rises each year, since many of the adenomas discovered and removed would otherwise have become cancerous several years later.
The yearly participation rate in colonoscopy screening has remained almost constant since 2003 at about four percent of eligible women and three percent of eligible men. Participants with inconspicuous examination results are offered a second examination free of charge after ten years. Thus, the total participation rate among those under 70, projected to the ten years between first and second screening colonoscopy, is 40 percent among women and 30 percent among men. "This is not bad for a beginning," says Hermann Brenner, "but if we succeeded in encouraging even more people to participate in the screening program - such as by sending personal invitations to examinations due - many more cancers could be prevented."
Helmholtz Association of German Research Centres
Colonoscopy Current Events and Colonoscopy News RSSPatient interest in video recording of colonoscopy
Colonoscopy is operator-dependent and substantial numbers of pre-cancerous polyps are missed during colonoscopy. Colonoscopies are often poorly documented, with only a few still photographs taken of anatomic landmarks and abnormal findings.
Panel calls for reducing colorectal cancer deaths by striking down barriers to screening
Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Despite evidence and guidelines supporting the value of screening for this disease, rates of screening for colorectal cancer are consistently lower than those for other types of cancer, particularly breast and cervical.
Virtual colonoscopy an effective colorectal cancer screening exam in Medicare age patients
Computed tomographic colonography (CTC), also known as virtual colonoscopy, remains effective in screening older patients for colorectal cancer (CRC), produces low referral for colonoscopy rates similar to other screening exams now covered by Medicare, and does not result in unreasonable levels of additional testing resulting from extracolonic findings, according to a study published in the February issue of Radiology.
Pitt researchers raise concern over frequency of surveillance colonoscopy
How often patients receive surveillance colonoscopy may need to be better aligned with their risks for colorectal cancer, according to two papers published this month by University of Pittsburgh School of Medicine researchers.
Study examines interval colorectal cancer despite surveillance colonoscopy
A new study examines the occurrence of interval colorectal cancer despite regular colonoscopy and highlights the importance of close follow-up for patients who have a history of advanced adenomas, which are precancerous polyps.
Fewer left-sided colorectal tumors observed after colonoscopies
The prevalence of left-sided advanced colorectal neoplasms was lower in participants in a community setting, but not right-sided advanced neoplams, who had received a colonoscopy in the preceding 10 years.
Colon cancer screening more effective earlier in day, UCLA study finds
The effectiveness of a screening colonoscopy may depend on the time of day it is performed. According to a new UCLA study, early-morning colonoscopies yielded more polyps per patient than later screenings, and fewer polyps were found hour by hour as the day progressed.
Residents play key role in CT colonography awareness and promoting the radiology specialty
Residents can serve a vital role in educating Congress, the medical community, and the general public regarding the efficacy of cutting-edge technologies like CT colonography (CTC) as well as the importance of radiologists' training and education and the role that radiologists serve in the provision of quality health care.
High-definition Colonoscopy Detects More Polyps, Mayo Clinic Researchers Say
High-definition (HD) colonoscopy is much more sensitive than standard colonoscopy in finding polyps that could morph into cancer, say researchers at the Mayo Clinic campus in Florida.
Study shows unsedated colonoscopy for colorectal cancer screening well accepted by patients
Researchers from Taiwan report in a new study that unsedated colonoscopy for primary colorectal cancer screening is well accepted in a majority of patients.
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