How much does colorectal cancer screening have?

In under-55s, the benefit of colorectal cancer screening is doubtful

07/26/2013

"The benefit of colorectal cancer screening at familial risk is unclear to patients under the age of 55," says the Institute for Quality and Efficiency in Health Care (IQWiG) in a recent press release. According to IQWiG, suitable studies are missing here in order to clearly prove the benefits of early detection. Some media now report that colon cancer screening for this group of people would be useless. "That's wrong," say experts. Rather, the "data situation" is currently too low to make concrete recommendations.

„It is unclear whether people who are younger than 55 years old and whose families already have a member suffering from colorectal cancer can benefit from a screening test“, explain the experts of the IQWiG in their final report published on Friday on the benefit of the screening test for familial colorectal cancer risk. Although the IQWiG clearly stated that 55-year-olds with at least one colorectal cancer case in first-degree relatives are 1.7- to 4.1-fold more likely to develop colorectal cancer than peers whose relationship to colorectal cancer has not yet occurred. But let this no direct conclusions about the purpose of screening tests.

Claim for colorectal cancer screening
Colorectal cancer or a so-called colorectal carcinoma forms in Germany „Both men and women are the second most common cancer and the second most common cause of cancer death“, the experts report. In about 25 percent of cases, a familial accumulation is observed. Screening examinations are available to all insured persons from the age of 50 to 54 years in the form of a stool examination once a year and in case of conspicuous findings in the form of a large colonoscopy (colonoscopy). From the age of 55, insured persons can choose whether to have a stool test every two years or a large colonoscopy, the IQWiG reports. Here, the policy has abolished the fixed age limits with the cancer screening and registration law, which has been in force since April 2013, in order to enable particularly vulnerable groups to claim colon cancer screening earlier.

Missing studies on the benefits of colorectal cancer screening
The IQWiG had according to own data the order, „to examine whether under-55s with relatives who have colorectal cancer are at an increased risk of self-infection and how reliably they can be identified.“ On the basis of the results, a possible extension of the claim to screening examinations should be decided. However, according to the IQWiG experts, the poor data situation does not make any statement on the benefit of early examinations in patients under the age of 55 years. (Fp)

Image: Dieter Schütz