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Utilization of surveillance colonoscopy in Germany: Current status and future concepts
Colorectal cancer is the second most common cancer in Germany. In most cases, colorectal cancer develops over a long period of time from precancerous lesions which can be removed during a colonoscopy. Individuals who had precancerous lesions should undergo regular surveillance colonoscopies. The recommended time interval for these surveillance colonoscopies varies according to the prior diagnosis. It depends on the severity of the precancerous lesions and thus on the related risk. However, there are indications that the recommended time intervals are often not met, namely, low risk patients too frequently undergo surveillance colonoscopies while those with high risk do it too rarely or not at all. Avoiding this over- and underuse could help to utilize the available resources sensibly and at the same time to improve the effectiveness of colorectal cancer screening.
The project aimed to investigate the extent to which there is inappropriate use of control colonoscopies in Germany and to examine its determinants. Based on the findings we are currently working on follow-up studies examining the consequences of over- and underuse, but also evaluating the effectiveness, utilization and quality of (screening) colonoscopies in Germany in general.