Background Information on the colonoscopy use is important to interpret patterns and trends
in colorectal cancer (CRC) incidence and mortality. In Germany, there is a lack of
studies providing detailed and precise information on colonoscopy use at the population
level.
Objective We aimed to describe 10-year prevalence of colonoscopy use overall and screening
colonoscopy stratified by sex, age, region and socioeconomic status (SES) based on
health insurance data.
Methods Using the German Pharmacoepidemiological Research Database (short GePaRD; claims
data of ~20% of the German population), we included persons continuously insured from
at least 2006 to 2017. Among these, we determined the number of persons with at least
one colonoscopy between 2008 and 2017 to calculate the 10-year prevalence of colonoscopy
use for the year 2017. We determined this prevalence for all colonoscopies and for
screening colonoscopy (reimbursable from age 55 onwards) stratified by sex, age, SES
and regional factors such as federal state, urban vs. rural district and density of
physicians in the district of residence.
Results Among 7,475,668 persons, 10-year prevalence of overall colonoscopy use in 2017 was
26% (women: 27%, men: 25%). In men, the prevalence by age was as follows (not all
age groups shown): 40-44 years: 11%, 50-54 years: 19%, 55-59 years: 31% (screening:
9%), 60-64 years: 41% (screening: 22%), 70-74 years: 43% (screening: 21%), 80-84 years:
40% (screening: 14%). In women, the prevalences were similar (differences ≤3 percentage
points). Stratification by SES and regional factors did not show relevant differences
in the prevalence.
Conclusion In 2017, about 40% of men and women in age group 60-84 had a colonoscopy in the past
10 years of which about 11%-24% had a screening colonoscopy. Analyses stratified by
SES and regional factors suggest that there are no relevant social or regional disparities
in utilization of colonoscopy in Germany.
