title: Declining Bowel Cancer Incidence and Mortality in Germany.
abstract: BACKGROUND
  In October 2002, screening colonoscopy from age 55 onward was introduced as part of the German national statutory cancer screening program. Screening colonoscopy is intended to lower both the mortality and the incidence of bowel cancer by enabling the detection and removal of precursor lesions.
  
  
  METHODS
  The authors studied trends in bowel cancer incidence and mortality in Germany from 2003 to 2012 on the basis of data from the epidemiological cancer registries and from cause-of-death statistics.
  
  
  RESULTS
  Over the period of investigation, the age-standardized incidence of bowel cancer (with the European population as a standard) fell from 66.1 to 57.0 cases per 100 000 persons per year (-13.8%) in men and from 42.6 to 36.5 per 100 000 persons per year (-14.3%) in women. In parallel with these changes, the age-standardized mortality from bowel cancer fell by 20.8% in men and by 26.5% in women. In the age groups 55-64, 65-74, and 75-84 years, the cumulative risk of receiving a diagnosis of bowel cancer fell by 17-26%; in persons under age 55, this risk fell by only 3% in men, but increased by 14% in women. Long-term data from the cancer registry in the German federal state of Saarland revealed that the incidence of bowel cancer, but not its mortality, had risen over the decades preceding the study; it was only during the period of investigation that the trend reversed itself.
  
  
  CONCLUSIONS
  Within 10 years of the introduction of screening colonoscopy in Germany, the incidence of bowel cancer in persons over age 55 fell by 17-26%, after having risen steadily over the preceding decades.
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ, Deutsches Krebsforschungszentrum), Heidelberg, Germany, Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany, German Consortium for Translational Cancer Research (DKTK, Deutsches Konsortium für Translationale Krebsforschung), German Cancer Research Center (DKFZ), Heidelberg, Germany, Saarland Cancer Registry, Saarbrücken, Germany, Institute of Social Medicine and Epidemiology, University Hospital Schleswig Holstein, Campus Lübeck and Institute of Cancer Epidemiology, University of Lübeck.
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
authors.forename: Petra
authors.initials: P
authors.lastname: Schrotz-King
authors.forename: Bernd
authors.initials: B
authors.lastname: Holleczek
authors.forename: Alexander
authors.initials: A
authors.lastname: Katalinic
authors.forename: Michael
authors.initials: M
authors.lastname: Hoffmeister
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000517:prevention & control*; D003113:Colonoscopy / Q000401:mortality* / Q000706:statistics & numerical data / Q000639:trends*; D055088:Early Detection of Cancer / Q000401:mortality* / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate