[Population-based incidence rates of colorectal neoplasms (2000 - 2006) - has systematic colonoscopy screening an impact on incidence? A combined analysis of cancer registry data of the Federal States of Bremen, Hamburg, Saarland and Schleswig-Holstein].
BACKGROUND
A quality assured colonoscopy screening was implemented in Germany in the year 2002. Persons aged 55 years or older with a health insurance are eligible. The primary aim of colonoscopy screening is the early detection of cancer. Furthermore, an incidence decrease is expected due to systematic adenomectomy. Up to date, neither a systematic monitoring of epidemiological data nor a mortality evaluation has been contracted by law.


METHODS
Four population-based cancer registries of the federal states Bremen, Hamburg, Saarland, and Schleswig-Holstein in Germany provided incidence data on colorectal cancers during 2000 - 2006. Age-standardised and stage-specific incidence rates and time trends (Joinpoint analysis and APC method) are reported.


RESULTS
Overall 34,100 colorectal cancers were registered, of which 91 % were within the screening-eligible age group. The incidence rise of in situ-cancers of the colon and rectum was significant. Changes in tumours of the T 3- and T 4-categories were not consistent.


CONCLUSIONS
There seems to be a temporal linkage between the implementation of a quality assured colonoscopy screening and the epidemiology of colorectal cancers in Germany. The observed changes cannot be attributed definitively to the screening activities, because required data are not available on the population level. A linkage of screenees and cancer data from registered tumour patients, which allows an individual follow-up and a mortality evaluation, would be desirable.
Institut für Krebsepidemiologie e. V., Lübeck. Annika.Waldmann@krebsregister-sh.de
A
A
Waldmann
A
A
Eberle
S
S
Hentschel
B
B
Holleczek
A
A
Katalinic
D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000517:prevention & control; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D005858:Germany; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009367:Neoplasm Staging; D011159:Population Surveillance; D012042:Registries; D015996:Survival Rate; D014600:Utilization Review / Q000639:trends