Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012-2018: Evidence from Claims Data of a Large Insurance.

Schneider, Rémi; Näpflin, Markus; Syrogiannouli, Lamprini; Bissig, Sarah; Tal, Kali; Bulliard, Jean-Luc; Ducros, Cyril; Senn, Oliver; Selby, Kevin; Bähler, Caroline; Blozik, Eva; Auer, Reto (2021). Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012-2018: Evidence from Claims Data of a Large Insurance. International journal of public health, 66, p. 1604073. Frontiers 10.3389/ijph.2021.1604073

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Objectives: Guidelines recommend colorectal cancer (CRC) screening by fecal occult blood test (FOBT) or colonoscopy. In 2013, Switzerland introduced reimbursement of CRC screening by mandatory health insurance for 50-69-years-olds, after they met their deductible. We hypothesized that the 2013 reimbursement policy increased testing rate. Methods: In claims data from a Swiss insurance, we determined yearly CRC testing rate among 50-75-year-olds (2012-2018) and the association with socio-demographic, insurance-, and health-related covariates with multivariate-adjusted logistic regression models. We tested for interaction of age (50-69/70-75) on testing rate over time. Results: Among insurees (2012:355'683; 2018:348'526), yearly CRC testing rate increased from 2012 to 2018 (overall: 8.1-9.9%; colonoscopy: 5.0-7.6%; FOBT: 3.1-2.3%). Odds ratio (OR) were higher for 70-75-year-olds (2012: 1.16, 95%CI 1.13-1.20; 2018: 1.05, 95%CI 1.02-1.08). Deductible interacted with changes in testing rate over time (p < 0.001). The increase in testing rate was proportionally higher among 50-69-years-olds than 70-75-year-olds over the years. Conclusions: CRC testing rate in Switzerland increased from 2012 to 2018, particularly among 50-69-years-olds, the target population of the 2013 law. Future studies should explore the effect of encouraging FOBT or waiving deductible.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Schneider, Rémi; Syrogiannouli, Lamprini; Bissig, Sarah Maria; Tal, Kali and Auer, Reto


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services






[189] Swiss Cancer Research = Krebsforschung Schweiz ; [4] Swiss National Science Foundation




Andrea Flükiger-Flückiger

Date Deposited:

18 Nov 2021 13:26

Last Modified:

19 Nov 2021 15:26

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Swiss health insurance colonoscopy colorectal cancer screening fecal occult blood test testing rates




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