Tötungsdelikte an 6- bis 13-jährigen Kindern in Deutschland. Eine kriminologische Untersuchung anhand von Strafverfahrensakten (1997 bis 2012)

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Association between socioeconomic and demographic characteristics and utilization of colonoscopy in the EPIC-Heidelberg cohort

We aimed to describe the utilization of colonoscopy and its association with sociodemographic characteristics within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heidelberg cohort study. We included 15 014 study participants (43% men) of the EPIC-Heidelberg cohort recruited between 1994 and 1998. At baseline recruitment, as well as in the 3-yearly follow-up surveys, study participants completed questionnaires on lifestyle, socioeconomic background variables, health status, and use of medications and medical services, including colonoscopy examinations. The present analyses focused on participants who completed the question on colonoscopy examination in all follow-up rounds. Our results show that by the end of the fourth follow-up round, more than half of all participants of the EPIC-Heidelberg cohort had had a colonoscopy. Colonoscopy was associated with some socioeconomic and demographic characteristics: a positive association with vocational training level as well as overall socioeconomic status level [International Standard Classification of Education (ISCED) classification]. A negative association was found for household size and employment status. Colonoscopy usage increased steeply within the subgroup of participants older than 55 years of age and decreased again within the subgroup of participants older than 75 years of age. Organized colorectal cancer screening should include a written invitation system, to overcome the problem of sociodemographic-related differential awareness of and attendance at colonoscopy examinations. Also, the high proportion of prescreened individuals should be taken into account to avoid unnecessary re-examinations

Sex- and site-specific differences in colorectal cancer risk among people with type 2 diabetes

Purpose: The prevalence of colorectal cancer is higher among patients with type 2 diabetes mellitus (T2D) than among patients without diabetes. Furthermore, men are at higher risk for developing colorectal cancer than women in the general population and also subsite-specific risks differ per sex. The aim was to evaluate the impact of T2D on these associations. Methods: A population-based matched cohort study was performed using data from the PHARMO Database Network. Patients with T2D were selected and matched (1:4) to diabetes free controls. Cox proportional hazards models were used to estimate hazard ratios (HRs) for CRC and its subsites. HRs were determined per sex and adjusted for age and socioeconomic status. The ratio of distal versus proximal colon cancer was calculated for people with T2D and controls per sex and stratified by age. Results: Over 55,000 people with T2D were matched to > 215,000 diabetes free controls. Men and women with T2D were 1.3 times more likely to develop colorectal cancer compared to controls. Men with T2D were at higher risk to develop distal colon cancer (hazard ratio (95% confidence interval), 1.42 (1.08–1.88)), and women with T2D were at higher risk for developing proximal colon cancer (hazard ratio (95% confidence interval), 1.58 (1.13–2.19)). For rectal cancer, no statistically significant risk was observed for both men and women. Conclusions: Sex-specific screening strategies and prevention protocols should be considered for people with T2D. More tailored screening strategies may optimize the effectiveness of colorectal cancer screening in terms of reducing incidence and mortality

Colorectal cancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy: a microsimulation modelling study

OBJECTIVE: To estimate benefits and harms of different colorectal cancer screening strategies, stratified by (baseline) 15-year colorectal cancer risk. DESIGN: Microsimulation modelling study using MIcrosimulation SCreening ANalysis-Colon (MISCAN-Colon). SETTING: A parallel guideline committee (BMJ Rapid Recommendations) defined the time frame and screening interventions, including

Recommendations for a step-wise comparative approach to the evaluation of new screening tests for colorectal cancer

BACKGROUND: New screening tests for colorectal cancer continue to emerge, but the evidence needed to justify their adoption in screening programs remains uncertain.METHODS: A review of the literature and a consensus approach by experts was undertaken to provide practical guidance on how to compare new screening tests with proven screening tests.RESULTS: Findings and recommendations from the review included the following: Adoption of a new screening test requires evidence of effectiveness relative to a proven comparator test. Clinical accuracy supported by programmatic population evaluation in the screening context on an intention-to-screen basis, including acceptability, is essential. Cancer-specific mortality is not essential as an endpoint provided that the mortality benefit of the comparator has been demonstrated and that the biologic basis of detection is similar. Effectiveness of the guaiac-based fecal occult blood test provides the minimum standard to be achieved by a new test. A 4-phase evaluation is recommended. An initial retrospective evaluation in cancer cases and controls (Phase 1) is followed by a prospective evaluation of performance across the continuum of neoplastic lesions (Phase 2). Phase 3 follows the demonstration of adequate accuracy in these 2 prescreening phases and addresses programmatic outcomes at 1 screening round on an intention-to-screen basis. Phase 4 involves more comprehensive evaluation of ongoing screening over multiple rounds. Key information is provided from the following parameters: the test positivity rate in a screening population, the true-positive and false-positive rates, and the number needed to colonoscope to detect a target lesion.CONCLUSIONS: New screening tests can be evaluated efficiently by this stepwise comparative approach. Cancer 2016;122:826-39. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.</p

Kinder und Jugendliche in der Coronavirus-Pandemie: psychosoziale und edukative Herausforderungen und Chancen : 8. Ad-hoc-Stellungsnahme - 21. Juni 2021

Die Coronavirus-Pandemie hat für Kinder und Jugendliche vielfältige Auswirkungen auf deren Bildung, soziale Interaktion, sozioemotionale Entwicklung, körperliche Aktivität sowie auf das psychische Wohlbefinden. Viele Betroffene werden in der Lage sein, die Auswirkungen zu überwinden. Manche dagegen werden mittel- und wahrscheinlich auch langfristig von den erlittenen Defiziten begleitet. Um diesen zu begegnen, empfiehlt die Nationale Akademie der Wissenschaften Leopoldina in der Ad-hoc-Stellungnahme „Kinder und Jugendliche in der Coronavirus-Pandemie: psychosoziale und edukative Herausforderungen und Chancen“ den Auf- und Ausbau von Unterstützungs- und Bildungsstrukturen. Diese sollten die derzeit bestehenden Ungleichheiten in Bildungs- und Entwicklungschancen nachhaltig adressieren und nicht nur pandemiebedingte Nachteile ausgleichen, sondern die Situation im Vergleich zum Status Quo vor der Pandemie verbessern

Framework and baseline examination of the German National Cohort (NAKO)

The German National Cohort (NAKO) is a multidisciplinary, population-based prospective cohort study that aims to investigate the causes of widespread diseases, identify risk factors and improve early detection and prevention of disease. Specifically, NAKO is designed to identify novel and better characterize established risk and protection factors for the development of cardiovascular diseases, cancer, diabetes, neurodegenerative and psychiatric diseases, musculoskeletal diseases, respiratory and infectious diseases in a random sample of the general population. Between 2014 and 2019, a total of 205,415 men and women aged 19–74 years were recruited and examined in 18 study centres in Germany. The baseline assessment included a face-to-face interview, self-administered questionnaires and a wide range of biomedical examinations. Biomaterials were collected from all participants including serum, EDTA plasma, buffy coats, RNA and erythrocytes, urine, saliva, nasal swabs and stool. In 56,971 participants, an intensified examination programme was implemented. Whole-body 3T magnetic resonance imaging was performed in 30,861 participants on dedicated scanners. NAKO collects follow-up information on incident diseases through a combination of active follow-up using self-report via written questionnaires at 2–3 year intervals and passive follow-up via record linkages. All study participants are invited for re-examinations at the study centres in 4–5 year intervals. Thereby, longitudinal information on changes in risk factor profiles and in vascular, cardiac, metabolic, neurocognitive, pulmonary and sensory function is collected. NAKO is a major resource for population-based epidemiology to identify new and tailored strategies for early detection, prediction, prevention and treatment of major diseases for the next 30 years. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10654-022-00890-5

Coronavirus-Pandemie: Die Feiertage und den Jahreswechsel für einen harten Lockdown nutzen : 7. Ad-hoc-Stellungnahme zr Coronavirus-Pandemie - 08.Dezember 2020

Die gegenwärtige Situation ist nach wie vor ernst und droht sich weiter zu verschärfen. Trotz des seit Anfang November in Deutschland geltenden Teil-Lockdowns sind die Infektionszahlen auf einem sehr hohen Niveau. Jeden Tag sterben mehrere Hundert Menschen. Die Krankenhäuser und insbesondere das medizinische Personal sind bereits jetzt an ihren Grenzen und die Gesundheitsämter überlastet. Um die Kontrolle über das Infektionsgeschehen zurückzuerlangen, empfiehlt die Nationale Akademie der Wissenschaften Leopoldina in der Ad-hoc-Stellungnahme „Coronavirus-Pandemie: Die Feiertage und den Jahreswechsel für einen harten Lockdown nutzen“ ein zweistufiges Vorgehen. Die Rahmenbedingungen ‒ Weihnachtsferien in Bildungseinrichtungen und eingeschränkter Betrieb in vielen Unternehmen und Behörden – bieten die Chance, in der Eindämmung der Pandemie ein großes Stück voranzukommen