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Cancer Epidemiol. 2012 Oct;36(5):417-20. doi: 10.1016/j.canep.2012.04.008. Epub 2012 Jun 5.

Colorectal cancer incidence in Germany: stage-shift 6 years after implementation of a colonoscopy screening program.

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  • 1Institute of Clinical Epidemiology, University Hospital Schleswig-Holstein, Campus Luebeck, RatzeburgerAllee 160, 23562 Luebeck, Germany.



In 2002, colonoscopy was introduced as a tool for colorectal cancer screening in Germany. The long-term objective was to reduce the incidence in colorectal cancer (CRC) by detection and removal of advanced adenomas. Currently, the effect of colonoscopy screening on the population-based incidence of CRC in Germany is unknown.


We provide data on stage-specific (age-standardized) incidence rates in three federal states in Germany, 6 years after the implementation of colonoscopy.


Between 2002 and 2008 a statistically significant decrease in CRC incidence could be observed (annually 3.0%, 95% confidence interval [CI]: -3.8; -2.2). The decline could be observed in all advanced tumor categories (T2, T3, and T4), whereas the incidence of in situ carcinomas (Tis) increased annually by 51.6% (95% CI: 28.0; 79.4) until 2004, and remained stable until 2008.


The observed changes cannot be attributed definitively to the screening activities, but the presented data support a possible causal association.

Copyright © 2012 Elsevier Ltd. All rights reserved.

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