[Effectiveness of screening colonoscopy in a community-based study].
In 2002 screening colonoscopy was introduced in Germany for the prevention of colorectal cancer (CRC) and CRC mortality. Individuals took part in a prospective study from October 2002 until September 2005 performed at a single centre for gastroenterology. Histopathological data, surgical-pathological stages and further follow-up events were recorded until 31st of December 2006. For screened individuals without symptoms, the data obtained were compared to those from age-matched patients who presented with clinical symptoms/signs and who underwent colonoscopy during the same period in time. A total of 5066 individuals underwent screening colonoscopy. In this group, colorectal cancer was detected in 46 individuals (0.9%). Endoscopic treatment was considered adequate for 21 cancers. In this group of 46 patients, 94.5% were classified into UICC stages I-II by pathological staging. In 504 screened individuals, colorectal polyps were detected (12.2%) and removed by polypectomy. Of these polyps, 16 were classified as cancer, 496 as adenomas and 1 as a carcinoid tumour. High grade dysplasia was noted in 41 polyps (8.3% of adenomas). In comparison, 4099 symptomatic patients underwent colonoscopy. In this group 100 cancers (2.4%) were detected. Advanced malignant tumours were noted in 39% of these; endoscopic treatment was feasible in 16% of the cancers. As of December 2006, cancer-related deaths were observed in 20% of symptomatic patients with CRC. Screening colonoscopy detects colorectal cancers in the early stages. Given the favourable prognosis in these stages, screening can reduce CRC-related mortality.
Hüppe
D
D
Gastroenterologische Gemeinschaftspraxis Herne, Herne. Hueppe@gastro-praxis-herne.de
Hartmann
H
H
Felten
G
G
Kemen
M
M
Tannapfel
A
A
Gillessen
A
A
Katalinic
A
A
D000236:Adenoma / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000517:prevention & control* / Q000532:radiotherapy / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003106:Colon / Q000473:pathology; D003111:Colonic Polyps / Q000175:diagnosis / Q000601:surgery; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000517:prevention & control* / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007417:Intestinal Polyps / Q000175:diagnosis / Q000601:surgery; D053208:Kaplan-Meier Estimate; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012002:Rectal Diseases / Q000175:diagnosis / Q000601:surgery; D012007:Rectum / Q000473:pathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors