Ascertainment of cancer cases in the German National Cohort (NAKO): Methods and initial results
BACKGROUND: is a prospective cohort study with 205 053 participants. Its goal is to identify risk factors for chronic diseases, including cancer. METHODS: We describe the methods of ascertaining cancer cases in NAKO (i.e., linkage with cancer registries and self-reporting), the incidence and prevalence figures obtained so far, and the ratios of observed to expected (O/E) case numbers. RESULTS: Case ascertainment identified 2774 existing cancer cases diagnosed within the five years prior to study enrollment and 4295 new cancer cases diagnosed up to five years after enrollment. Cancers of the breast, prostate, lung, and colorectum made up 55% of the incident cases. Fewer incident cases were found than would have been expected on the basis of incidences in the general population (O/E ratio 0.80, 95% confidence interval [0.76;0.83] for the first two-years of prospective follow-up); the O/E ratio varied across tumor sites (breast 1.02, prostate 1.12, lung 0.38, colorectum 0.62). Possible explanations include healthy volunteer bias, delayed reporting, as well as incomplete data collection from registries and self-reporting. CONCLUSION: Rising case numbers for the most common types of cancer are expected in the next few years and will enable comprehensive epidemiological analysis of the risk factors of cancer.
Authors
- Tobias Hartz (ORCID: https://orcid.org/0000-0002-1704-0338)
- Karin Halina Greiser (ORCID: https://orcid.org/0000-0003-3213-8285)
- Ulrike Haug (ORCID: https://orcid.org/0000-0002-1886-2923)
- Iris Pigeot (ORCID: https://orcid.org/0000-0001-7483-0726)
- Joachim Kieschke
- Lena Koch‐Gallenkamp (ORCID: https://orcid.org/0000-0001-7290-906X)
- Kathrin Guenther
- Alexander Katalinic (ORCID: https://orcid.org/0000-0003-0490-1554)
- Dorothee Zoller
- Manuela Harries (ORCID: https://orcid.org/0000-0001-5238-0103)
- Heike Minnerup (ORCID: https://orcid.org/0000-0002-9706-7599)
- Verena Katzke (ORCID: https://orcid.org/0000-0002-6509-6555)
- Anna Köttgen (ORCID: https://orcid.org/0000-0002-4671-3714)
- Alexander Kluttig (ORCID: https://orcid.org/0000-0003-4446-9938)
- Peter Schirmacher (ORCID: https://orcid.org/0000-0002-0950-3339)
- Katharina Nimptsch (ORCID: https://orcid.org/0000-0001-7877-205X)
- Karen Steindorf (ORCID: https://orcid.org/0000-0001-5215-5651)
- Andrea Werdecker
- Henry Völzke
- Ulrich Mueller
- Verena A. Katzke
- Carolina Klett-Tammen
- Florian Karpa
- Alice Nennecke
- Renée Fortner
- Christoph Stallmann
- Wolfgang Hoffmann
- Wolfgang Lieb
- Hansjörg Baurecht
- Volker Arndt
- Ute Mons
- Michael Hoffmeister
- Nina Ebert
- Wolfang Ahrens
- André Karch
- Börge Schmidt
- Nadia Obi
- Hans Gert Fabian
- Hermann Brenner
- Anne von Rüsten
- Rafael Mikolajczyk
- Enno Swart
- Claudia Meinke-Franze
- Sabine Luttmann
- Volker Harth
- Klaus Berger
- Matthias B Schulze
- Bernd Holleczek
- Katharina Hofmann
- Rudolf Kaaks
- Hajo Zeeb (ORCID: https://orcid.org/0000-0001-7509-242X)
- Heiko Becher
- Andreas Stang
- Annette Peters
- Michael Leitzmann
- Lilian Krist
- Tobias Pischon
- Martin Meyer
- Stefan N Willich
- Wolfgang Lieb
- Lilian Krist
- Peter Schirmacher
- Rudolf Kaaks
- Annette Peters
- Klaus Berger
- Tobias Pischon
- Heiko Becher
- Michael Leitzmann
- Enno Swart
- Bernd Holleczek
- Hajo Zeeb
- Claudia Meinke-Franze
- Volker Arndt
- Hermann Brenner
- Martin Meyer
- Nadia Obi
- Wolfgang Hoffmann
- Volker Harth
- Andreas Stang
- Iris Pigeot
- Michael Hoffmeister
- Henry Völzke
- Rafael Mikolajczyk
- Ute Mons
- Matthias B. Schulze
- André Karch
- Stefan N. Willich
- Börge Schmidt
- Hansjörg Baurecht
Publication Details
- Journal
- Deutsches Ärzteblatt international
- Published
- 2026-07-28
- DOI
- https://doi.org/10.3238/arztebl.m2026.0061
- Primary Topic
- Global Cancer Incidence and Screening
- Type
- article
- Field-Weighted Citation Impact
- 0.00