The Future of Colorectal Cancer Screening Is Digital

Germany has debated healthcare digitalization for decades, yet screening uptake remains low. This is a pitty, especially in the case of colorectal cancer. It is one of the cancers where early detection can make a major difference. When the disease is found early, the chances of successful treatment are often very good [1]. Yet in many countries, including Germany, screening options already available are still underused [2].

Colorectal cancer screening shows particularly clearly why following through with digitalization matters. This is not just about making processes more efficient – it is about real chances of cure. When colorectal cancer is detected early, the outlook is very good, which makes it even more concerning that participation in screening in a country like Germany has remained far below its potential for years.

While only a small share of eligible people (around 20%) in Germany make use of available screening options, countries such as the Netherlands and England achieve participation rates of close to 70% [2]. There is a simple reason why information can increase participation: psychological barriers such as uncertainty, avoidance, or fear of a possible positive result make people avoid screening. Many people do not actively reject screening – they postpone it. This is why effective education and simple screening options are important [3].

That is why one question is becoming increasingly urgent: how can screening be made simpler and more accessible so that more people actually take part?

Dr. Berndt Birkner – gastroenterologist and President of Netzwerk gegen Darmkrebs – sees digitalization as an important part of the answer. In his interview with Preventis, he explains why digital tools will play an increasingly important role in colorectal cancer screening and why smartphone-based solutions can open up new pathways.

“It is an important issue that has been raised repeatedly in Germany in the past, but never really followed through. That is exactly why it matters so much now. We are looking ahead, and the future will bring developments we simply will not be able to ignore. In early detection in particular, digitalization will play a major role. 2 years ago, lawmakers in Germany passed the Act to Accelerate the Digitalization of the Healthcare System though legislation has already been in place for 30 years. Why  does it need to be accelerated in the first place? Germany has been moving far too slowly on healthcare digitalization for years – even though the structures to support it should really have been in place long ago.”

“There has been a clear shift in the methods available for colorectal cancer screening. Endoscopy and stool testing remain the standard. But we now have a whole range of new methods that will move colorectal cancer screening forward. Still, we need digital support – and we will not succeed without it. To make one example, there is a study from 2021 in which people who were candidates for colorectal cancer screening were given information through a digital source – explaining why screening matters and how it works. Compared with standard counselling, this electronic, digital source of information led to significantly more people actually going to screening – almost 40% more overall.”

“Yes because we need to take into account that a cancer diagnosis comes as a shock to the people affected. That is why it is so important to meet people early, for example right from the first conversation they have with their doctor, and give them a sense of reassurance and confidence.”

“Yes simple screening options are absolutely essential for higher participation. We already have a digital test for colorectal cancer screening for quite some time now too. SmarTest FIT® Home is a smartphone-based rapid test that can be performed at home. After taking a small stool sample, the result is read via the smartphone camera in the app and evaluated quantitatively. The whole procedure takes patients only 20 minutes and they don’t need to send anything to the lab. The results can even be shared with the healthcare professional.”

“In principle, I would always recommend a stool test for home use, simply because it gives people more freedom in how they make that decision. The test can be done at home, which means I am independent in terms of time and place. On top of that, the smartphone-based FIT test provides me with an immediate quantitative result as soon as I took the stool sample and applied it to the test cassette. I receive a precise result without having to send anything to a lab, and I can immediately act on it. With the conventional pathway, several days pass between performing the test and receiving the result creating anxiety and uncertainty – what is the result, and what am I supposed to do next? A test that allows immediate action and evaluation is not only comfortable it removes anxiety”

“This is an easy answer. Relevant studies have been carried out, including by the German Cancer Research Center (DKFZ). These studies showed that there is no qualitative difference between laboratory analysis and analysis using the smartphone-supported stool test, where the smartphone camera reads and quantitatively evaluates the test strip. In other words: the study by the DKFZ confirms that the test is as good as the lab test.”

Go to DKFZ Study Summary

“We need to digitalize our healthcare system so that we can generate comprehensive health data and learn how to work with those data. These data are crucial for building risk profiles. That requires the involvement of partners, public institutions, and new organizational standards. Solutions like smartphone-based rapid tests as well as wearable diabetes patches are one of many examplery solutions that can help make early detection more accessible and make screening pathways more effective for everybody. The real added value only comes when this information does not remain isolated, but when it is embedded in a structure where it can be meaningfully used, interpreted, and applied for decision-making. Digital approaches create the opportunity to integrate health data into broader healthcare systems, such as the electronic patient record. This is an essential step if screening is to be understood not as isolated, but as connected and integrated – because after 30 years of legislation without meaningful progress, it is no longer a question of what is possible, but of finally implementing that what already exist.”

Dr. Berndt Birkner is a gastroenterologist and President of Netzwerk gegen Darmkrebs e.V. For many years, he has been committed to improving awareness, strengthening screening structures, and increasing participation in colorectal cancer screening in Germany.

Preventis is a German diagnostics company with scientific roots in laboratory medicine. For more than 20 years, Preventis has been developing innovative rapid tests and smartphone-supported diagnostic solutions to make early detection more accessible, practical, and better connected to modern healthcare pathways.