The introduction of screening colonoscopy in Germany is showing results: Within ten years of the start of this screening program for the early detection of colorectal cancer, the number of new cases has significantly dropped in the age groups 55 years and over. This is the conclusion drawn by Hermann Brenner, German Cancer Research Center, Heidelberg and co-authors in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2016; 113: 101-6).
Based on data from the German epidemiological cancer registries and the cause-of-death statistics, the researchers reviewed the development of colorectal cancer incidence and mortality rates between 2003 and 2012. During this period, about 20 to 30 percent of eligible persons participated in the screening colonoscopy program. After decades of increase, the age-standardized colorectal cancer incidence declined by 13.8 percent in men and 14.3 percent in women, while the age-standardized colorectal cancer mortality dropped by 20.8 percent in men and 26.5 percent in women. This sharp decline in incidence was selectively observed in the age groups 55 years and over.
Screening colonoscopy from age 55 years was added to the German national statutory cancer screening program in October 2002. Thanks to its ability to detect precursors of colorectal cancer, such as colorectal adenoma, this method has the potential to not only reduce mortality but also the incidence of colorectal cancer.
The authors expect that this downward trend in colorectal cancer incidence and mortality will continue and even accelerate in the years ahead.