World Health Matters: Germany – Early detection: Colorectal cancer rates declining

by Gary Finnegan: The introduction of colonoscopy screening in Germany is showing results, according to a new study which points to a sharp fall in death rates from the disease.

Within ten years of the start of a screening programme for the early detection of colorectal cancer, the number of new cases has significantly dropped in the age groups 55 years and over, according to Hermann Brenner and colleagues at the German Cancer Research Center, Heidelberg.

The findings are reported in a paper published in Deutsches Ärzteblatt International and are based on data from German epidemiological cancer registries, along with cause-of-death statistics.

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 indivdiuals participated in the screening colonoscopy programme.

After decades of increases, the age-standardised colorectal cancer incidence declined by 13.8 percent in men and 14.3 percent in women, while the age-standardised 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.

Colonoscopy screening from age 55 years was added to the German national statutory cancer screening programme 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 said they expect that this downward trend in colorectal cancer incidence and mortality will continue – and may even accelerate – in the years ahead.