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@ARTICLE{Guo:144396,
      author       = {F. Guo$^*$ and C. Chen$^*$ and B. Schöttker$^*$ and B.
                      Holleczek and M. Hoffmeister$^*$ and H. Brenner$^*$},
      title        = {{C}hanges in colorectal cancer screening use after
                      introduction of alternative screening offer in {G}ermany:
                      {P}rospective cohort study.},
      journal      = {International journal of cancer},
      volume       = {146},
      number       = {9},
      issn         = {1097-0215},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2019-01849},
      pages        = {2423-2432},
      year         = {2020},
      note         = {146 (9), 2423-24322020#EA:C070#LA:C070#},
      abstract     = {In October 2002, screening colonoscopy was added to the
                      German colorectal cancer (CRC) screening program as an
                      alternative to fecal occult blood test (FOBT). We aimed to
                      evaluate the change in CRC screening use after introduction
                      of the dual screening offer and to assess determinants of
                      screening use. Data were drawn from a population-based
                      cohort study initiated during 2000-2002 in Germany (n =
                      5,845, age range at recruitment: 50-75 years). We
                      conducted both cross-sectional and longitudinal analyses to
                      obtain uptake rates of CRC screening based on four waves of
                      data. Age-group specific proportions of participants having
                      had FOBT within 2 years remained essentially unchanged at
                      $61-67\%$ between 2000 and 2002 (1st wave) and 2005-2007
                      (3rd wave). The proportions of participants having undergone
                      screening colonoscopy within 10 years increased from
                      $23-29\%$ to $46-57\%,$ leading to a substantial overall
                      increase in being up-to-date with CRC screening from
                      $66-68\%$ to $77-80\%.$ In 2008-2010 (4th wave), FOBT use
                      declined and colonoscopy use continued to increase. Obesity
                      was significantly associated with lower prevalence of being
                      up-to-date with FOBT (odds ratio [OR] at 8-year follow-up
                      0.68; $95\%$ confidence interval [CI], 0.58-0.80) and
                      screening colonoscopy (OR, 0.73; $95\%$ CI, 0.62-0.86).
                      Also, smokers were less likely to have ever used FOBT (OR,
                      0.54; $95\%$ CI, 0.40-0.75) or colonoscopy (OR, 0.75; $95\%$
                      CI, 0.63-0.90) compared to nonsmokers. After the
                      introduction of dual screening offer, the overall adherence
                      to CRC screening steeply increased, mainly due to an
                      increase in screening colonoscopy uptake. Screening tests
                      kept being underused by obese people and smokers who are at
                      elevated CRC risk.},
      cin          = {C070 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31291471},
      doi          = {10.1002/ijc.32566},
      url          = {https://inrepo02.dkfz.de/record/144396},
}