Informierte Teilnahme an Früherkennungsuntersuchungen: Ergebnisse einer Befragung unter GKV-Versicherten

Schmuker, Caroline; Zok, Klaus

doi:10.32745/9783954664023-2

Cited by 7 publications

(3 citation statements)

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“…Apart from the fact that the offered CT screening examinations are currently not approved on a generic level, there is a concern that these problems are also not addressed in a personal consultation and that the special features of early detection compared to conventional diagnostics in medical care are not sufficiently reflected by service providers. The documented lack of information has been confirmed by the results of a current representative survey among statutory health insurance patients regarding screening measures [11]. According to survey participants, the information needed to make an informed decision was not sufficiently provided by the doctors and the benefits were overemphasized compared to the risks.…”

Section: Discussionmentioning

confidence: 99%

Early Detection of Diseases by Radiological Imaging: New Legal Situation and Evaluation of Service Offers using CT Examinations as an Example

Brix

Nekolla

Griebel

2019

Fortschr Röntgenstr

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Background Radiological imaging offers promising prospects for the early detection of diseases. In Germany, the legal framework for such examinations was created by the Radiation Protection Law, which entered into force on December 31, 2018. Under this law, each specific type of radiodiagnostic screening of non-communicable diseases needs an approval on a generic level (permission) by a federal statutory ordinance, defining the specific requirements and conditions. It is the aim of the present paper, (i) to present in detail the new legal situation and (ii) to assess actual service offers for the screening of asymptomatic persons using CT examinations as an example. Method In February 2019, radiology institutions in Germany illegally offering on the Internet CT examinations for the screening of lung and colon cancer or coronary artery disease were identified. For each type of examination, 50 pertinent websites were evaluated particularly regarding the general information on the offered screening examination and the concrete procedure. Results In the vast majority of cases, the information provided on the websites was inadequate and disproportionately emphasized the benefits over the risks of the screening examination. Moreover, the offers differed substantially with respect to the age and risks factors of potential participants, the frequency of examinations, the screening procedure, and the diagnostic workup. Conclusion The evaluated service offers strongly substantiate the need to define requirements and conditions regarding radiological screening examinations by statutory ordinances, in order to ensure an informed decision of potential screening participants as well as the benefit versus the risks of the procedures. Key Points: Citation Format

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Section: Discussionmentioning

confidence: 99%

Early Detection of Diseases by Radiological Imaging: New Legal Situation and Evaluation of Service Offers using CT Examinations as an Example

Brix

Nekolla

Griebel

2019

Fortschr Röntgenstr

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“…Unfortunately, the German health care system opens different ways of getting screening mammography outside the official screening program (opportunistic screening). The results of a recent survey showed that 73% of women in the screening age group had a mammography in the last 2 years (83% for “ever” had a mammogram) which is in compliance with earlier surveys . Insofar a realistic screening rate for Germany might be clearly higher than 50%, likely about 70% and comparable to other European countries.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer incidence and mortality before and after implementation of the German mammography screening program

Katalinic

Eisemann

Kraywinkel

et al. 2019

Intl Journal of Cancer

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Effective population-based mammography screening should impact breast cancer (BC) incidence, age and stage-specific incidence and BC mortality. We aim to investigate such effects in a time period of 10 years after implementation of the German mammography screening program. Data on 323,719 breast cancer patients from 2003 to 2014 for defined regions covering a population of 30 million inhabitants and official mortality data from 1998 to 2016 for almost the whole of Germany were used. We compared incidence and mortality rates for the prescreening time period (2003/2004) and the latest available data (2013/2014 and 2015/2016, respectively) and performed trend analyses using joinpoint regression models. In the screening exposed age groups (50-59 and 60-69 years), BC incidence showed a typical prevalence peak with the introduction of the mammography screening, mainly driven by an increase of early-stage BC. For Stage III and IV BC incidence in 2013/2014 was 24.2 and 23.0% (age group 50-59 years) and 28.3 and 24.2% (age group 60-69 years) lower than in the prescreening period. From 2003/2004 to 2015/2016 BC mortality decreased by 25.8 and 21.2%, respectively. As corresponding trends in nonexposed age groups were distinctly unfavorable, the reduction of late-stage BC incidence and BC mortality in the screening exposed age groups in Germany is most likely to be attributed to the introduction of the national mammography screening program. These positive effects are bought at the cost of a moderate occurrence of overdiagnosis, especially by a sharp increase of in situ cancers.

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“…1 Participation rates in the German MSP are around 50% per screening round and 83% of women in a survey said they had participated at least once over a 10-year time frame. 13,14 Information on whether and when invitations were issued is not available due to data protection reasons; screening attendance, however, can be identified using specific health insurance claims codes.…”

Section: Introduction Backgroundmentioning

confidence: 99%

Effectiveness of Mammography Screening on Breast Cancer Mortality – A Study Protocol for Emulation of Target Trials Using German Health Claims Data

Braitmaier¹,

Kollhorst²,

Heinig³

et al. 2022

CLEP

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Background The efficacy of mammography screening in reducing breast cancer mortality has been demonstrated in randomized trials. However, treatment options - and hence prognosis – for advanced tumor stages as well as mammography techniques have considerably improved since completion of these trials. Consequently, the effectiveness of mammography screening under current conditions is unclear and controversial. The German mammography screening program (MSP), an organized population-based screening program, was gradually introduced between 2005 and 2008 and achieved nation-wide coverage in 2009. Objective We describe in detail a study protocol for investigating the effectiveness of the German MSP in reducing breast cancer mortality in women aged 50 to 69 years based on health claims data. Specifically, the proposed study aims at estimating per-protocol effects of several screening strategies on cumulative breast cancer mortality. The first analysis will be conducted once 10-year follow-up data are available. Methods and Analysis We will use claims data from five statutory health insurance providers in Germany, covering approximately 37.6 million individuals. To estimate the effectiveness of the MSP, hypothetical target trials will be emulated across time, an approach that has been demonstrated to minimize design-related biases. Specifically, the primary contrast will be in terms of the cumulative breast cancer mortality comparing the screening strategies of “never screen” versus “regular screening as intended by the MSP”. Ethics and Dissemination In Germany, the utilization of data from health insurances for scientific research is regulated by the Code of Social Law. All involved health insurance providers as well as the responsible authorities approved the use of the health claims data for this study. The Ethics Committee of the University of Bremen determined that studies based on claims data are exempt from institutional review. The findings of the proposed study will be published in peer-reviewed journals.

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Informierte Teilnahme an Früherkennungsuntersuchungen: Ergebnisse einer Befragung unter GKV-Versicherten

Cited by 7 publications

References 0 publications

Early Detection of Diseases by Radiological Imaging: New Legal Situation and Evaluation of Service Offers using CT Examinations as an Example

Early Detection of Diseases by Radiological Imaging: New Legal Situation and Evaluation of Service Offers using CT Examinations as an Example

Breast cancer incidence and mortality before and after implementation of the German mammography screening program

Effectiveness of Mammography Screening on Breast Cancer Mortality – A Study Protocol for Emulation of Target Trials Using German Health Claims Data

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