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@ARTICLE{Heisser:180638,
      author       = {T. Heisser$^*$ and M. Hoffmeister$^*$ and H. Tillmanns and
                      H. Brenner$^*$},
      title        = {{I}mpact of demographic changes and screening colonoscopy
                      on long-term projection of incident colorectal cancer cases
                      in {G}ermany: {A} modelling study.},
      journal      = {The lancet / Regional health. Europe},
      volume       = {20},
      issn         = {2666-7762},
      address      = {[Amsterdam]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2022-01443},
      pages        = {100451},
      year         = {2022},
      note         = {#EA:C070#LA:C070#LA:C120#},
      abstract     = {Demographic aging is expected to increase the number of
                      colorectal cancer (CRC) cases in many countries. Screening
                      for CRC can substantially reduce the disease burden but its
                      use has remained rather limited in Germany. We aimed to
                      quantify the expected impact of demographic aging on the
                      future CRC burden and the potential to reduce that burden by
                      increased use of screening colonoscopy offers in Germany.We
                      obtained sex- and age-specific data on colonoscopy use from
                      AOK, the biggest health insurance provider in Germany, and
                      combined these with the projected demographic development
                      and current CRC incidence rates. We estimated the number of
                      new CRC cases until 2060, assuming screening colonoscopy use
                      to be constant or to increase to between 1·5 and 3 times
                      the current levels.Ten-year screening colonoscopy
                      utilization rates were low $(<20\%$ in both sexes in all age
                      groups). Assuming no change in screening colonoscopy use,
                      the overall annual caseload was predicted to increase from
                      approximately 62,000 cases in 2020 to more than 70,000 cases
                      by the year 2040 and more than 75,000 cases by 2050. To
                      avoid increasing case numbers, an increase of screening
                      colonoscopy use to more than 3 times current levels would be
                      needed.At current levels of screening use, the strong
                      effects of the demographic aging imply that the CRC caseload
                      will significantly increase in the decades to come. CRC
                      screening efforts will need to be substantially increased to
                      even maintain the current level of incident cases.German
                      Federal Ministry of Education and Research (grant
                      01GL1712).},
      keywords     = {Adherence (Other) / Colonoscopy (Other) / Colorectal cancer
                      (Other) / Forecasting (Other) / Screening (Other)},
      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:35799615},
      pmc          = {pmc:PMC9253902},
      doi          = {10.1016/j.lanepe.2022.100451},
      url          = {https://inrepo02.dkfz.de/record/180638},
}