Original ResearchClinical—Alimentary TractEfficacy of a Nationwide Screening Colonoscopy Program for Colorectal Cancer
Section snippets
Inclusion and Exclusion Criteria
To be eligible for colonoscopy screening, patients had to be 55 years of age or older, asymptomatic with respect to colorectal symptoms, and members of statutory health insurance. Patients with symptoms suggestive of CRC or known risk groups for CRC such as familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer are taken care of outside this program and not included in this analysis.
Participating Physicians and Quality Control
Only physicians with specific qualifications (gastroenterologists, colorectal surgeons, or
Results
Data of 2,821,392 nationwide documented screening colonoscopies from January 2003 to December 2008 were available for analysis. The documented screening colonoscopies were performed by more than 2100 office-based physicians throughout Germany. A total of 45% of these physicians were gastroenterologists, 45% internists, and 5% surgeons. In 5% of cases, the speciality of the endoscopist was unknown. A total of 55.6% of all screening subjects were women; the average age was 64.4 (SD, 6.9) years
Discussion
We report here the results of 2,821,392 colonoscopies performed in 6 years in an opportunistic population-based colonoscopy screening program in Germany. Previous studies have been limited by smaller numbers and including only expert centers, thus making it unknown if these results could be transferred to everyday practice. Our cohort includes all screening colonoscopies performed throughout Germany and, to our knowledge, is the largest database on screening colonoscopies worldwide.
There are 2
Acknowledgments
C.P.P. and L.A. contributed equally to this work.
The authors thank all of the endoscopists performing screening colonoscopies who provided the data for analysis and for their cooperation in gathering additional information about their patients.
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Conflicts of interest The authors disclose no conflicts.
Funding Supported by the National Association of Statutory Health Insurance Physicians and the Association of Statutory Health Insurance Fund (data registry and monitoring process). The funding sources had no influence on study design, data collection, monitoring, analysis, and interpretation of results or the decision to submit the manuscript for publication. W. Schmiegel has been supported by the PURE research grant of the Federal Estate of North Rhine Westphalia, Germany.