Declining Bowel Cancer Incidence and Mortality in Germany An Analysis of Time Trends in the First Ten Years After the Introduction of Screening Colonoscopy
Declining Bowel Cancer Incidence and Mortality in Germany An Analysis of Time Trends in the First Ten Years After the Introduction of Screening Colonoscopy
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DOI：
10.3238/arztebl.2016.0101
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发表时间：
2016-02-19
影响因子：
7.7
通讯作者：
Hoffmeister, Michael
中科院分区：
文献类型：
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作者：
Brenner, Hermann;Schrotz-King, Petra;Hoffmeister, Michael
背景：2002年10月，55岁以后的结肠镜筛查作为德国国家法定癌症筛查项目的一部分被引入。筛查结肠镜检查的目的是降低死亡率和肠癌的发病率，使检测和去除前驱病变。方法：作者根据流行病学癌症登记处和死因统计数据，研究了2003年至2012年德国肠癌发病率和死亡率的趋势。结果：在调查期间，肠癌的年龄标准化发病率（以欧洲人口为标准）男性从每年每10万人66.1例下降到57.0例（-13.8%），女性从每年每10万人42.6例下降到36.5例（-14.3%）。与此同时，肠癌的年龄标准化死亡率在男性中下降了20.8%，在女性中下降了26.5%。在55-64岁、65-74岁和75-84岁年龄组中，接受肠癌诊断的累积风险下降了17-26%；在55岁以下的人群中，这种风险在男性中只下降了3%，但在女性中增加了14%。来自德国联邦萨尔州癌症登记处的长期数据显示，在这项研究之前的几十年里，肠癌的发病率有所上升，但死亡率没有上升；只是在调查期间，这一趋势才出现逆转。结论：在德国引入筛查性结肠镜检查后的10年内，55岁以上人群的肠癌发病率下降了17-26%，而在过去的几十年里，肠癌发病率稳步上升。
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.Method: 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.Conclusion: 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.