The colonoscopy uptake rate of just 2.6% compared with those entitled to be screened seems too small to be a reliable basis for projections.
In this context, it would be interesting to know how many of these 2.6% were actual screening colonoscopies and how many indicated colonoscopies are included in that rate. The effect of the measure may be substantially overestimated as a result.
In all experience, patients are far more easily persuaded to undergo colonoscopy screening if they are given indications of increased risk (irregular bowel movements, family history, or a positive test for fecal occult blood in the stools). Might reimbursement considerations be a contributing factor too? Early detection colonoscopy is reimbursed outside the regular budget.
Colonoscopy screening may therefore make an only seemingly large contribution to the prevention and early detection of colorectal cancers in Germany, because of—rather than in spite of—low uptake rates.
References
- 1.Brenner H, Altenhofen L, Hoffmeister M. Eight years of colonoscopic bowel cancer screening in Germany: Initial findings and projections. Dtsch Arztebl Int. 2010;107(43):753–760. doi: 10.3238/arztebl.2010.0753. [DOI] [PMC free article] [PubMed] [Google Scholar]