# Anonymous forensic evidence collection (AFC) after sexual offenses: a challenge in gynecological care—data from 13 years and 7 months at a University Hospital

## TL;DR

This study tracks the use of anonymous forensic evidence collection in gynecological care over 13 years, highlighting its growing importance and challenges in handling sexual offense cases.

## Contribution

The study provides a long-term analysis of AFC utilization and identifies persistent clinical challenges in its implementation.

## Key findings

- Annual AFC cases increased from 8 to 25 between 2012 and 2024, with an average annual growth of 17%.
- Common issues included improper storage and incorrect labeling of forensic samples.
- The study emphasizes the need for proper funding and structured procedures to ensure quality care for victims.

## Abstract

Anonymous (or confidential) forensic evidence collection (AFC; German: Anonyme Spurensicherung [ASS]) following sexual offenses plays a critical role in the initial care of affected individuals. Comprehensive execution of this procedure presents a significant challenge in the clinical routine care of gynecologists, as legal requirements, court-admissible documentation of injuries, and forensic evidence preservation often lead to uncertainty. The implementation of forensic evidence collection as a statutory health insurance benefit, following the Measles Protection Act (Masernschutzgesetz), has been effective in North Rhine-Westphalia since March 1, 2025, and is currently being formalized in contractual agreements. The objective of this study is to track the utilization of AFC, raise awareness of this topic, and identify common problems associated with its execution.

Systematic compilation of annual case numbers for anonymous forensic evidence collection (AFC) was performed from June 2011 to December 2024 at the Department of Obstetrics and Gynecology, University Hospital Cologne. This was followed by a statistical evaluation of the percentage increase and the annual mean values.

A total of 177 cases were documented at the University Hospital Cologne. Between 2012 and 2024, the annual case numbers increased from eight to 25 cases. The average number of cases examined annually during the observation period was 13.15. This corresponds to an average annual increase of approximately 17%, totaling 215% over 11 years, when considering 2012 as the first complete year for data analysis. Frequent issues encountered in clinical practice include improper storage (until transport to the Institute of Legal Medicine) and incorrect labeling of collected samples.

The observed increase in the number of alleged victims of sexual violence requiring examination supports the health policy assumption that structured and correct forensic evidence collection is becoming increasingly vital. Adequate funding for the examination and the storage of evidence carriers is mandatory for long-term quality assurance. This is the only way to ensure optimal support and care for presumed victims in these stressful situations.

The online version contains supplementary material available at 10.1007/s00404-026-08388-1.