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@ARTICLE{Guo:168678,
      author       = {F. Guo$^*$ and C. Chen$^*$ and B. Holleczek and B.
                      Schöttker$^*$ and M. Hoffmeister$^*$ and H. Brenner$^*$},
      title        = {{S}trong {R}eduction of {C}olorectal {C}ancer {I}ncidence
                      and {M}ortality {A}fter {S}creening {C}olonoscopy:
                      {P}rospective {C}ohort {S}tudy {F}rom {G}ermany.},
      journal      = {The American journal of gastroenterology},
      volume       = {116},
      number       = {5},
      issn         = {1572-0241},
      address      = {Alphen aan den Rijn, The Netherlands},
      publisher    = {Wolters Kluwer Health, Inc.},
      reportid     = {DKFZ-2021-00986},
      pages        = {967 - 975},
      year         = {2021},
      note         = {#EA:C070#LA:C070#},
      abstract     = {A claimed advantage of colonoscopy over sigmoidoscopy in
                      colorectal cancer (CRC) screening is prevention of CRC not
                      only in the distal colon and rectum but also in the proximal
                      colon. We aimed to assess the association of screening
                      colonoscopy use with overall and site-specific CRC incidence
                      and associated mortality.Information on use of screening
                      colonoscopy as well as potential confounding factors was
                      obtained at baseline in 2000-2002, updated at 2-, 5-, 8-,
                      and 17-year follow-up from 9,207 participants aged 50-75
                      years without history of CRC in a statewide cohort study in
                      Saarland, Germany. Covariate-adjusted associations of
                      screening colonoscopy with CRC incidence and mortality,
                      which were obtained through record linkage with the Saarland
                      Cancer Registry and mortality statistics up to 2018, were
                      assessed by Cox proportional hazards models with
                      time-varying exposure information.During a median follow-up
                      of 17.2 years, 268 participants were diagnosed with CRC and
                      98 died from CRC. Screening colonoscopy was associated with
                      strongly reduced CRC incidence (adjusted hazard ratio [aHR]
                      0.44, $95\%$ confidence interval [CI] 0.33-0.57) and
                      mortality (aHR 0.34, $95\%$ CI 0.21-0.53), with stronger
                      reduction for distal (aHRs 0.36, $95\%$ CI 0.25-0.51, and
                      0.33, $95\%$ CI 0.19-0.59, respectively) than for proximal
                      cancer (aHRs 0.69, $95\%$ CI 0.42-1.13, and 0.62, $95\%$ CI
                      0.26-1.45, respectively). Nevertheless, strong reduction of
                      mortality from proximal cancer was also observed within 10
                      years after screening colonoscopy (aHR 0.31, $95\%$ CI
                      0.10-0.96).In this large prospective cohort study from
                      Germany, screening colonoscopy was associated with strong
                      reduction in CRC incidence and mortality.},
      cin          = {C070 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33929378},
      doi          = {10.14309/ajg.0000000000001146},
      url          = {https://inrepo02.dkfz.de/record/168678},
}