Colorectal cancer is the second most common cancer in women in Germany, and the third most common cancer in men. According to the Robert Koch Institute (RKI), more than 58,000 new cases were reported in 2016 (26,000 women, 32,000 men). Furthermore, it has also been proven that first-degree relatives of patients with colorectal cancer have a higher than average chance of developing the disease. This topic was recently the subject of a publication in the journal “Clinical Gastroenterology and Hepatology” entitled “Prevalence of a First-Degree Relative with Colorectal Cancer and Uptake of Screening Among Persons 50 to 54 Years Old” published with the participation of the Chair of Epidemiology headed by Prof. Dr. Stefanie Klug. The journal has an impact factor of 7.958.
For the cross-sectional study, which was conducted from 2015 to 2016 at several locations in Germany (including Munich, Dresden and Stuttgart), a total of 160,000 people aged between 40 and 54 years were randomly selected and contacted via the residents' registration office. A total of around 29,000 people answered the questionnaire, which was completed online or in paper-and-pencil form. The aim was to determine the prevalence of a first-degree relative with colorectal cancer based on the available data. “Among the 29,000 participants, 9.4 percent stated that they knew someone in their immediate family environment suffering from colorectal cancer”, explains Prof. Stefanie Klug. “In addition, the prevalence of colorectal cancer among participants increased with age."
The second step involved using the data to determine which persons directly related to the colorectal cancer risk group have already undergone a colonoscopy procedure. At 54.5 percent, the proportion of persons in the risk group was higher than the proportion of persons without any previous history of the desease in their family. Nevertheless, according to Prof. Klug, many people would still not necessarily be willing to undergo a colonoscopy. “However, this reluctance can be fatal, especially for older people, as they certainly have a higher risk of developing colorectal cancer”, explains the head of the Chair of Epidemiology. “Therefore, we hope that the results will shake up the German population a bit and encourage them to go for screening.”
A public screening program has been in place since October 2002 offering a test for hidden blood in the stool (hemoccult test) for patients over the age of 50. Since 2019, an organized colorectal cancer screening program has been offered in Germany. Eligible persons are invited to participate by their health insurance company. In addition, men from the age of 50 and women from the age of 55 are entitled to a colonoscopy for early detection. “Throughout Germany, however, only ten to eleven percent of people eligible for screening take part, as a colonoscopy is quite time-consuming and many people find it unpleasant”, said Prof. Klug.
However, the epidemiologist advises people to stick to the current recommendations of the screening program. In principle, more attention should be paid to the risk of colorectal cancer and the availability of risk-adapted screening for younger people should also be promoted more widely. Prof. Klug believes that politicians and the health care system, including general practitioners and family doctors, are responsible for addressing these issues.
Prof. Dr. Stefanie Klug
Chair of Epidemiology
phone: 089 289 24950
Text: Romy Schwaiger
Photos: „Clinical Gastroenterology and Hepatology“/Chair of Epidemiology