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DOI: 10.1055/s-0029-1245602
© Georg Thieme Verlag KG Stuttgart · New York
Bevölkerungsbezogene Darmkrebsinzidenz im Zeitraum 2000 bis 2006 – Deuten sich erste Auswirkungen des Koloskopie-Screenings an? Eine gemeinsame Auswertung der Krebsregisterdaten aus Bremen, Hamburg, dem Saarland und Schleswig-Holstein
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-HolsteinPublication History
Manuskript eingetroffen: 23.4.2010
Manuskript akzeptiert: 9.7.2010
Publication Date:
01 December 2010 (online)
![](https://www.thieme-connect.de/media/zfg/201012/lookinside/thumbnails/10.1055-s-0029-1245602-1.jpg)
Zusammenfassung
Hintergrund: Seit 2002 haben krankenversicherte Personen in Deutschland ab dem Alter von 55 Jahren Anspruch auf qualitätsgesicherte Screening-Koloskopien. Primäres Ziel des Screenings ist die frühe Diagnose, langfristig wird eine Senkung der Darmkrebsneuerkrankungen durch die Adenomektomie erwartet. Bislang wurde weder ein systematisches Monitoring epidemiologischer Daten noch eine Mortalitätsevaluation gesetzlich festgeschrieben. Material und Methoden: Die epidemiologischen Krebsregister der Länder Bremen, Hamburg, Saarland und Schleswig-Holstein stellten Inzidenzdaten kolorektaler Karzinome bereit. Altersstandardisierte sowie stadienspezifische Inzidenzraten wurden berechnet, zeitliche Trends durch Joinpoint-Analysen und APC-Methode ermittelt. Ergebnisse: Im Zeitraum 2000 – 2006 wurden rund 34 100 Darmtumoren registriert, 91 % davon in der Altersgruppe 55 + . Der Inzidenzanstieg der In-situ-Tumoren in Kolon und Rektum war signifikant, die Verläufe fortgeschrittener Tumorstadien zeigten keine einheitliche Veränderung. Diskussion: In zeitlichem Zusammenhang mit der Einführung des Koloskopie-Screenings sind Veränderungen in der Epidemiologie kolorektaler Tumoren zu beobachten. Die Veränderungen können jedoch nicht eindeutig mit dem Screening in Verbindung gebracht werden, weil entsprechende bevölkerungsbezogene Daten nicht zur Verfügung stehen. Notwendig wäre ein Abgleich der Screeningteilnehmer mit den Krebsregister-Datenbeständen, um ein Follow-up und eine Mortalitätsevaluation zu ermöglichen.
Abstract
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. Materials and 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. Discussion: 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.
Schlüsselwörter
kolorektales Karzinom - Koloskopie-Screening - Mortalität - Inzidenz
Key words
colorectal carcinoma - coloscopy screening - mortality - incidence
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Dr. Annika Waldmann
Institut für Krebsepidemiologie e. V.
Ratzeburger Allee 160 (Haus 50)
23538 Lübeck
Email: Annika.Waldmann@krebsregister-sh.de