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@ARTICLE{Zhan:131634,
      author       = {T. Zhan$^*$ and T. Hielscher$^*$ and A. Bilge and T. Giese
                      and C. Schäfer and J. F. Riemann and M. P. Ebert and S.
                      Belle},
      title        = {{I}nvitation letters increase participation in colorectal
                      cancer screening - results from an observational study.},
      journal      = {Zeitschrift für Gastroenterologie},
      volume       = {55},
      number       = {12},
      issn         = {1439-7803},
      address      = {Stuttgart [u.a.]},
      publisher    = {Thieme},
      reportid     = {DKFZ-2017-06266},
      pages        = {1307 - 1312},
      year         = {2017},
      abstract     = {Background and Aim Participation rates in the German
                      colorectal cancer screening program are low. Starting in
                      2013, a large health insurance plan in Bavaria, Germany, is
                      sending an additional invitation letter to insured
                      individuals when they turn 50 or 55 years and become
                      eligible for participation in the program. The letter
                      provides detailed information on colorectal cancer
                      screening. We assessed the impact of the invitation letter
                      on utilization rates. Methods Insurance claims data of a
                      total of 48 343 individuals who had turned 50 or 55 years
                      between 2012 to 2014 were reviewed for utilization rates of
                      screening colonoscopy and fecal blood tests. Utilization
                      rates 1 year prior (2012) and 2 years after introduction of
                      the invitation letter (2013 and 2014) were compared.
                      Furthermore, providers of colorectal cancer screening were
                      determined. Results Within 6 months after turning 50 or 55
                      years, $8.8 - 10.2 \%$ of all insured individuals
                      participated in colorectal cancer screening, with the
                      majority being females. After the introduction of the
                      invitation letter, a moderate increase in participation
                      rates could be observed (increase to $109 \%$ [RR
                      $101.7 - 117.3 \%,$ p = 0.02] in 2014). The uptake
                      rate of screening colonoscopy was significantly higher in
                      recipients of the letter (increase to $138.4 \%$ [RR
                      $110.4 - 173.8 \%,$ p = 0.0043] in 2013 and to
                      $149 \%$ [RR $119.5 - 186.3 \%,$ p = 0.0003] in
                      2014). Furthermore, a significantly higher proportion of
                      general practitioners and gastroenterologists provided
                      colorectal cancer screening in individuals receiving the
                      invitation letter. Conclusions Introduction of an
                      invitation letter can improve participation rates for
                      colorectal cancer screening.},
      cin          = {B110 / C060},
      ddc          = {610},
      cid          = {I:(DE-He78)B110-20160331 / I:(DE-He78)C060-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29212101},
      doi          = {10.1055/s-0043-121347},
      url          = {https://inrepo02.dkfz.de/record/131634},
}