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Cologne – Organized colon cancer screening within the framework of statutory health insurance (GKV) currently starts in Germany when the insured person turns 50. The Institute for Quality and Efficiency in Health Care (IQWiG) has investigated the question of whether screening should be started earlier for people with a familial risk of colon cancer.

“No comparative intervention study of the screening chain was identified in people under 50 years of age with a familial risk. There is therefore no evidence of benefit or harm from early detection of colorectal cancer in people under 50 years of age with a familial risk,” the institute’s working group reports in a preliminary report. Interested parties can comment on it until September 9.

In a second step, the IQWiG team examined whether and, if so, how findings on early detection of colorectal cancer in the general population aged 50 or over can be transferred to people under 50 with a familial risk of colorectal cancer. However, according to the preliminary report, the evidence for this is also very low.

“Overall, it remains unclear whether the proven benefit of colorectal cancer screening for people aged 50 or over who have no known familial risk of colorectal cancer could also be achieved in a similar way for people under 50 who have a familial risk of colorectal cancer,” the scientists report.

Colon cancer is the second most common cancer in women worldwide and the third most common cancer in men. According to the Robert Koch Institute, it is the third most common cause of cancer death in Germany.

According to the IQWiG report, in about 70 percent of cases, colorectal cancer develops from slowly growing, initially benign neoplasms (adenomas) that form in the mucous membrane of the colon and rectum.

They can grow through various stages, penetrate into the deeper layers of the intestinal wall and become malignant. According to the working group, around 25 to 30 percent of carcinomas arise from sessile serrated lesions (SSLs).

According to the IQWiG, screening tests for colon cancer have two goals: firstly, to detect and remove adenomas before they become malignant. Secondly, to identify carcinomas before they become symptomatic and metastasize. © hil/aerzteblatt.de