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Background : In 2002, colonoscopy was introduced as a tool for colorectal cancer screening in Germany. The long-term objective was to reduce the incidence in colorectal cancer (CRC) by detection and removal of advanced adenomas. Currently, the effect of colonoscopy screening on the population-based incidence of CRC in Germany is unknown. Methods : We provide data on stage-specific (age-standardized) incidence rates in three federal states in Germany, 6 years after the implementation of colonoscopy. Results : Between 2002 and 2008 a statistically significant decrease in CRC incidence could be observed (annually 3.0%, 95% confidence interval [CI]: −3.8; −2.2). The decline could be observed in all advanced tumor categories (T2, T3, and T4), whereas the incidence of in situ carcinomas (Tis) increased annually by 51.6% (95% CI: 28.0; 79.4) until 2004, and remained stable until 2008. Conclusion : The observed changes cannot be attributed definitively to the screening activities, but the presented data support a possible causal association.

Summary Objectives In Germany the estimation of a population based annual incidence of community acquired pneumonia (CAP) in adults has been referred to the denominator problem. To estimate a population based annual incidence of CAP in an urban German area we compared the incidence estimated on four different approaches. Methods We estimated the annual incidence on the basis of the covered population of sentinel practices from Luebeck participating in the German competence network CAPNETZ. We estimated the incidence on the basis of a population based survey, on the basis of the mortality and lethality in Luebeck, and on the basis of data of the regional Association of Statutory Health Insurance Physicians ("Kassenarztliche Vereinigung (KV) Schleswig-Holstein"). Results The annual incidence of CAP in Luebeck was 3.7/1000 inhabitants (95% confidence interval (CI) 2.4–5.5), 6.0/1000 inhabitants, 8.7/1000 inhabitants (95% CI 8.2–9.1), or 10.1/1000 inhabitants (95% CI 9.6–10.5) depending on the approach of estimation. According to this, in Germany we would expect 400,000–680,000 new CAP cases per year. Conclusions The true incidence of CAP in Luebeck might range between 3.7 and 10 per 1000 inhabitants. Comparisons with the rates in the literature are difficult due to the differences in the applied methods.