If a tumor has already metastasized, the chances of recovery and usually also the treatment options decrease. The earlier cancer is diagnosed and treated, the better the prognosis. This is why cancer screening (early cancer detection) plays a very important role.
The statutory health insurance companies offer various screening programs. Taking advantage of these offers can actually save your life.
However, many types of cancer cannot be detected at an early stage. Statutory cancer screening therefore essentially consists of the early detection of
Depending on age and gender, different examinations are recommended for the early detection of cancer.
Irrespective of the statutory cancer screening, everyone should have regular
by inspecting and palpating them. Specialists provide information on the best way to do this and what to look out for.
Specific cancer screening for women
Cancer screening is usually carried out by a gynecologist.
Cancer screening of the reproductive organs
For women aged 20 and over, cancer screening of the reproductive organs includes
- An anamnesis interview with questions about symptoms, bleeding disorders and discharge,
- examination of the cervix,
- the removal of examination material from the cervix and cervicalsmear (cancer smear) and
- a cytological examination (Pap test) and
- a gynecological palpation examination and
- a final consultation.
Breast cancer screening
As a rule, from the age of 30, cancer screening of the breast (mamma) includes
- a medical history interview with questions about changes and complaints in the breast,
- an examination and palpation of the breast and lymph nodes
- instructions for self-examination of the breast.
From the age of 50, an X-ray examination of both breasts is also carried out as part of the mammography screening. This is carried out every two years until the end of the 70th year of life.
Specific cancer screening for men
From the age of 45, statutory screening provides for cancer screening of the reproductive organs, which includes
- inspection and palpation of the external genital organs and
- and palpation of the prostate and lymph nodes.
are in the foreground.
Cancer screening for both sexes
Cancer screening of the skin
Skin cancer screening is carried out every two years from the age of 35. It consists of
- a medical history interview with questions about changes and complaints of the skin, as well as
- an examination of the entire skin on the whole body, including the hairy head and all folds of the body skin, in particular
- armpits,
- groin,
- gluteal cleft,
- crevices between fingers and toes,
- underbust area and
- belly button.
Cancer screening of the rectum and the rest of the colon
Cancer screening of the rectum and the rest of the colon includes
- from the age of 50, a test for hidden blood in the stool (annually until the age of 54) and
- from the age of 55, two colonoscopies every ten years or
- a new test for hidden blood in the stool every two years.
During skin cancer screening, the doctor checks for conspicuous moles, among other things © Pixel-Shot | AdobeStock
Overview of cancer screening
Cancer screening examinations recommended for women
The following cancer screening examinations are recommended for women by statutory health insurance providers, sorted by age:
- from the age of 20: annual genital examination with a specific history of menstrual irregularities, discharge, smear test and cytological examination
- from the age of 30: once a year breast examination with
- medical history of complaints and changes,
- palpation of the breast and regional lymph nodes and
- instructions for self-monitoring
- from 35 years: every two years inspection of the skin
- from 50 to 54 years: once a year colon and rectal examination with palpation of the rectum and hemocult test for blood in the stool
- from 50 to 69 years: mammography screening every two years, invitation to breast X-ray examination by certified screening units.
- from the age of 55: colonoscopy twice every ten years or, alternatively, a hemococcal test every two years.
Cancer screening examinations recommended for men
The statutory health insurance funds recommend the following cancer screening examinations for men, sorted by age:
- Cancer screening for men aged 35 and over: skin inspection every two years
- Cancer screening for men aged 45 and over: prostate and genital examination once a year with a history of changes, complaints and palpation of the prostate and lymph nodes
- Cancer screening for men aged 50 to 54: once a year colon and rectal examination with palpation of the rectum and hemocult test for blood in the stool
- Cancer screening for men aged 55 and over: colonoscopy twice every ten years or, alternatively, a haemoccult test every two years.
The term cancer screening plus refers to extended cancer screening examinations. They are usually not covered by statutory health insurance.
Depending on the doctor's practice or medical facility, these are individually compiled service packages. They usually include the examinations covered by health insurance as well as supplementary or alternative procedures. The doctor invoices these directly to the patient as individual health services (IGeL).
The additional examinations are sometimes quite expensive and not always useful for the individual patient. It is a matter of weighing up possible cancer risk factors against the increased costs. You should discuss with the doctor whether the additional examinations are of benefit in the individual case.
If there is an increased risk for the patient, some of the examinations may make sense. For example, there is an increased risk if there is a family history of cancer or if there is frequent contact with carcinogenic materials.
General extended cancer screening
For the early detection of abdominal tumors, cancer screening plus an ultrasound examination of the abdomen is included. In most cases
are examined more closely.
For the early detection of skin cancer, the skin is inspected with a special magnifying glass (dermatoscope). This examination is called a reflected light examination.
A test for blood in the urine should provide indications of bladder or kidney cancer.
A general blood test with determination of liver and kidney values and blood lipids is also possible.
Testing the blood for certain tumor markers can also provide indications of cancer. For example, a bladder tumor screening test (NMP 22) is used for the early detection of bladder cancer.
An ultrasound examination of the abdomen, such as the kidneys, can provide indications of cancer © LIGHTFIELD STUDIOS | AdobeStock
Extended cancer screening for women
For women, various ultrasound examinations (sono-check) are also part of extended cancer screening. Examples of these are
In addition, a laboratory test for chlamydia
- to ensure fertility (fertility) and to protect
- to protect against premature birth or miscarriage and myocardial infarction(heart attack).
is offered.
A test for human papillomavirus(HPV test) is also possible. A positive HPV test can indicate an increased risk of cervical cancer.
Occasionally, the following tumor markers are also offered for early cancer detection:
- SCC or Cyfra 21-1 for the early detection of cervical cancer
- Cyfra 21-1 or beta-HCG for the early detection of uterine cancer
- Beta-HCG, AFP [alpha-fetoprotein], CA 125 or inhibin B for the early detection of ovarian cancer
- CA 15-3 or CEA for the early detection of breast cancer.
Extended cancer screening for men
Extended cancer screening for men often includes
- a transrectal ultrasound examination(TRUS) of the prostate and
- a blood test using a PSA test for the early detection of prostate carcinoma (prostate cancer).
An ultrasound examination of the testicles can provide additional certainty in the early detection of testicular cancer. The determination of certain tumor markers in the blood (e.g. beta-HCG, AFP) serves the same purpose.
Examinations for the early detection of breast cancer
Palpation of the breast and lymph nodes
The statutory cancer screening program includes an annual palpation examination of the breast and armpits. Lymph nodes are located in the armpits. To do this, the patient raises her arms above her head. The doctor can then palpate the breasts and armpits.
Women are also instructed on how to palpate their breasts themselves once a month.
Mammography
Mammography is a special X-ray examination of the breast. It can be used to detect small breast tumors that are not yet palpable or otherwise visible.
Breast cancer can be treated very effectively at an early stage. Early diagnosis of breast cancer is therefore particularly important.
During the mammogram, the breast is lightly compressed between two radiolucent Plexiglas disks. Some women find this procedure unpleasant or even painful. It may therefore be advisable to have this screening examination in the first half of the menstrual cycle. The sensitivity of the breast to pressure is usually less then.
Mammography is an X-ray examination and therefore involves a certain amount of radiation. However, this is kept to a minimum thanks to improved X-ray technology.
Performing a mammogram for cancer screening © RFBSIP | AdobeStock
Ultrasound examination of the breast
Ultrasound examination (sonography) of the breast is inferior to mammography in terms of accuracy. Ultrasound is better able to visualize dense, gland-rich breast tissue than mammography. This is why the examination is more suitable for younger women.
Sonography is very good at distinguishing benign cysts from breast lumps.
Examinations for the early detection of bowel cancer
Hemoccult test
Bowel tumors often bleed. One possibility for the early detection of bowel cancer is therefore to examine the stool for blood.
These are often such small amounts of blood that they are not visible to the naked eye. A hemocult test is carried out for this purpose. This is a test for hidden blood in the stool, i.e. blood that is not visible to the naked eye.
For the hemocult test, stool samples are placed on test strips and examined for traces of blood in the laboratory.
Colonoscopy (colonoscopy)
During a colonoscopy, a colonoscope is used to examine the inside
- of the rectum,
- the large intestine and
- the last part of the small intestine
are examined. An optical instrument on a movable tube is inserted through the anus into the intestine. The doctor can then examine the intestinal mucosa for changes.
Colonoscopy can be used to detect early stages of bowel cancer and polyps (benign growths).
Virtual colonoscopy
In a virtual colonoscopy, the bowel is examined without inserting instruments into the bowel.
Instead, computer or magnetic resonance imaging is used to take sectional images of the bowel from the outside. The computer then assembles the sectional images into three-dimensional images. This allows the doctor to examine the inside of the bowel.
Virtual colonoscopy appears to be equivalent to conventional colonoscopy in terms of the informative value of its images.
Examinations for the early detection of cervical cancer
Genital examination
The gynecologist palpates the abdomen and inspects in detail
- the labia,
- vagina and
- the cervix.
The uterus and ovaries can be palpated from the outside via the abdominal wall. The area of the uterus can also be reached via the anus for palpation if there are any abnormalities.
The cervix and neck of the womb are examined via the vagina using a vaginal speculum. The doctor dilates the vagina with the speculum. He then examines the tissue in the area of the inner vagina and cervix. To do this, the doctor uses a colposcope (a special magnifying glass).
Pap test for the early detection of cancer
The Pap test is a cytological examination of the uterus. The gynecologist takes a smear, i.e. some cell material from the uterine orifice and cervix. He uses a spatula, a small brush or a cotton swab.
In the laboratory, the smear is examined under a microscope for cell changes.
HPV test
The HPV test can be used to detect an infection with human papillomaviruses (HPV). These viruses are the main cause of cervical cancer.
A tissue sample is taken from the cervix and examined for the presence of HPV genetic material using molecular biology.
The best way to prevent cervical cancer is an HPV vaccination. It immunizes women against the dangerous viruses. However, the vaccination only makes sense for young girls.
Examinations for the early detection of skin cancer
Skin cancer screening
During the skin cancer screening, the doctor asks the patient whether they have noticed any changes to their skin.
He also looks for abnormalities during the visual examination of the skin. This could be an excessive number of moles, for example.
If skin cancer or its precursors are suspected, a dermatologist must carry out a thorough examination using a dermatoscope.
Reflected light examination (reflected light microscopy, dermoscopy)
In a reflected light examination, skin changes are examined with a so-called reflected light microscope. A reflected light microscope is a magnifying glass fitted with a halogen lamp.
Under high magnification, the doctor can also inspect deeper skin layers and assess them relatively reliably. A general practitioner or dermatologist usually carries out the reflected light examination.
Examinations for the early detection of prostate cancer
Digital rectal palpation of the prostate for the early detection of cancer
During the digital rectal palpation examination, the doctor inserts his finger into the rectum. This allows him to feel small irregularities on the surface of the prostate.
However, deeper tumors cannot be detected in this way.
Transrectal ultrasound examination of the prostate
During a transrectal ultrasound examination (TRUS) of the prostate, an ultrasound probe is inserted into the rectum. This allows the doctor to examine the prostate.
However, this ultrasound examination is often only recommended in combination with a palpation examination or PSA test.
