Colonoscopies to check for bowel cancer under used in Germany

5 July 2008

Under 2% of persons aged over 55 in Germany use colonoscopies for early detection of cancer, even though the statutory health insurance funds have covered the costs since 2002. Statutory health insurance allows two screening colonoscopies in 10 years

This was shown by an analysis of the Bavarian Colonoscopy Database published in the current edition of Deutsches Ärzteblatt International [1].

The authors evaluated over 245,000 colonoscopies performed by the Bavarian Association of Statutory Health Insurance Physicians in 2006. The analysis showed that colonoscopy is an established, reliable and safe procedure for the early detection of colorectal cancer.

The procedure detects an intestinal lesion in a quarter of  patients and  as many as 1% of these lesions are due to a carcinoma. Advanced adenomas are often precursors of carcinoma and were found in one of twelve investigations.

In spite of the high rate of detection of intestinal cancer and the low risk for the patient, far too few patients exploited the chance of a check-up.

Colonoscopies for the early detection of cancer are only performed annually on 2% of persons aged over 55. To this must be added 4% who have a colonoscopy performed as part of a follow-up or for the diagnosis of symptoms.

If this is extrapolated to a period of 10 years — the intended interval between two check-ups — it leaves 40% of people aged over 55 who do not have a check-up.


1. Epidemiology and Quality Control of 245 000 Outpatient Colonoscopies. Deutsches Ärzteblatt International 2008; 105(24): 434-40.

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