Colonoscopy use in a country with a long-standing colorectal cancer screening programme: evidence from a large German survey.

BACKGROUND: Given the potential colonoscopy has in prevention and early detection of colorectal cancer (CRC), its overall use within a population is a meaningful parameter to estimate the future CRC burden. We aimed to examine overall prevalence and correlates of colonoscopy use in Germany, a country with a long-standing, opportunistic CRC screening programme.
METHODS: The data were collected in 2004 through the Health Care Access Panel, a nationally generalisable survey of German households. The sample comprised 15,810 men and women aged 50 to 70 years without a personal history of cancer.
RESULTS: Overall, 36 % of respondents reported to have had at least one colonoscopy in the past (25 % once and 11 % more than once). Prevalence of colonoscopy use strongly increased by age (from 25 % to 43 % in age groups 50 - 54 and 65 - 70, respectively), but hardly differed by sex. Previous faecal occult blood testing (FOBT) was the most important correlate of colonoscopy use in either sex.
CONCLUSIONS: Our survey from 2004, when FOBT was still the most important screening tool in Germany, suggests that more than one third of the German population underwent colonoscopy at least once up to age 70. While introduction of screening colonoscopy is expected to impact on overall colonoscopy use in the long run, these data can serve as point of reference to assess the extent and the patterns of such changes. © Georg Thieme Verlag KG Stuttgart · New York.