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Alcohol consumption influences sodium-water homeostasis. However, the effect of alcohol on vasopressin levels is controversial. The aim of the present study was to evaluate physiological changes of alcohol consumption on the stable vasopressin surrogate marker copeptin. In addition, we aimed at investigating the effect of additional sodium and/or water consumption on plasma sodium, osmolality, and copeptin levels. Ten healthy men underwent four interventions in random order: 1) beer consumption only, 2) beer consumption with additional water, 3) beer consumption with additional stock, or 4) water consumption only. Fluid consumption was equal between interventions and calculated to reach a blood alcohol concentration of 0.8‰ in the beer interventions. Blood and urinary samples were taken at six time points over the observation period of 720 min. The primary end point was the mean difference in copeptin levels 90 min after the start of fluid consumption, which showed no in-between group differences ( P = 0.4). However, a higher total urinary volume excretion in all alcohol compared with water interventions was observed ( P = 0.01). Furthermore, plasma copeptin, sodium, and urinary osmolality levels increased significantly at the end of the observation period in all alcohol compared with water-only interventions ( P = 0.02). In conclusion, initial copeptin suppression does not differ between alcohol or water interventions but seems to be prolonged in the alcohol interventions. This leads to increased volume loss followed by a counterregulation with increased copeptin levels and water retention after 720 min in alcohol compared with interventions. Additional sodium and/or water consumption with alcohol did not change the observed alcohol-induced effects.

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.

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AIMS OF THE STUDY: Canton Vaud, Switzerland, implemented an organised colorectal cancer  screening programme with colonoscopy and faecal occult blood tests in 2015, 4 to 6 years ahead of neighbouring cantons. Before its implementation, nearly half of Swiss citizens were already up to date with screening, primarily from opportunistic colonoscopies. We hypothesised that earlier implementation of an organised programme would be associated with greater increases in colorectal cancer testing rates. METHODS: We analysed Swiss health insurance claim data from CSS, a Swiss health insurer covering 16% of the Swiss population and 10% of canton Vaud. We stratified 50–69-year-olds into groups from Vaud, its four neighbouring cantons (Fribourg, Geneva, Neuchâtel and Valais), and the rest of Switzerland. We analysed overall, faecal occult blood test and colonoscopy testing rates for each year between 2010 and 2018. RESULTS: The overall testing rate increased from 7.6% in 2010 to 11.6% in 2018 (+4.0%) in Vaud, from 6.1% to 9.3% (+3.2%) in neighbouring cantons and from 7.4% to 8.6% (+1.2%) in the rest of Switzerland. The faecal occult blood test rate increased between 2016 and 2018 from 2.9% to 4.1% (+1.2%) in Vaud and from 1.7% to 2.6% (+0.9%) in neighbouring cantons, but it decreased from 3.1% to 1.5% (–1.6%) in the rest of Switzerland. The colonoscopy rate increased in all cantons, from 4.7% to 7.5% in Vaud (+2.8%), from 4.4% to 6.7% in neighbouring cantons (+2.3%) and from 4.3% to 7.1% in the rest of Switzerland (+2.8%). By 2018, 40% of faecal occult blood tests and 26% of colonoscopies in Vaud occurred in the organised programme. Those who completed an faecal occult blood test within the Vaud programme were younger, had fewer comorbidities and were more likely to have a high-deductible health plan than those tested outside the programme. CONCLUSIONS: Colorectal cancer testing rates increased between 2010 and 2018, with greater absolute increases in Vaud than in neighbouring cantons or the rest of Switzerland. Faecal occult blood test use increased in both Vaud and neighbouring cantons, possibly reflecting changes in testing patterns by general practitioners. By 2018, 40% of colonoscopies and 26% of faecal occult blood tests occurred within the screening programme.