gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

Colonoscopy and fecal occult blood test use in Germany: results from a large insurance-based cohort

Meeting Abstract

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  • Christian Stock - Deutsches Krebsforschungszentrum, Heidelberg
  • Ingrid Schubert - PMV Forschungsgruppe, Köln
  • Peter Ihle - PMV Forschungsgruppe, Köln
  • Hermann Brenner - Deutsches Krebsforschungszentrum, Heidelberg

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds294

doi: 10.3205/11gmds294, urn:nbn:de:0183-11gmds2942

Published: September 20, 2011

© 2011 Stock et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background and aims: Colonoscopy and guaiac-based fecal occult blood test (FOBT) are recommended and offered for colorectal cancer (CRC) screening in Germany. We aimed to explore their utilization in a large insurance-based cohort.

Study population and methods: Claims data collected between 2000 and 2008 from 170,493 persons insured by a large health insurance plan (AOK Hesse – Die Gesundheitskasse) in the federal state of Hesse, Germany. Percentages of persons with recent utilization of CRC screening-related procedures were determined. Additionally, multiple test use and CRC screening providers were ascertained.

Results: After inception of the current CRC screening programme in 2002, colonoscopy utilization rates varied only slightly and FOBT use decreased in persons aged ≥50 years. At the end of 2008, the age-standardized percentages of persons who had undergone colonoscopy within ≤10 years were 23% for males and 26% for females. Proportions of persons who had used FOBT within ≤1 year were 14% for males and 22% for females. Patient education had been utilized by 38% of eligible persons and was increasingly followed by screening colonoscopy. For women, practices specialized in gynecology were the main providers of FOBT (93%) and patient education (61%).

Conclusions: This study provides new insights into the interrelated utilization of colonoscopy, FOBT, and patient education in Germany and may particularly be informative for the design of strategies to increase CRC screening uptake. It indicates that gender differences in CRC screening test use could result to a large extent from general visits to different types of specialist physicians involved in the CRC screening process.