Colon cancer usually develops from initially benign changes, such as colon polyps, which can progress to malignant tumors over time. Early detection of colon cancer is particularly important starting at age 50, as the risk of colon cancer increases after this age. Women and men aged 50 and older are covered by their public health insurance for screenings that are considered methods of early detection. If the results are abnormal, further evaluation is conducted by a doctor. A colonoscopy is the most reliable method for early detection because it can identify colorectal polyps immediately. This significantly reduces the risk of developing colorectal cancer. All services are covered by health insurance, so insured individuals can undergo screening without any obstacles.
The following video explains how these develop:
If the malignant growths are located in the large intestine, they are called colon carcinomas. If they are located in the rectum, they are called rectal carcinomas.
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Colorectal cancer screening is part of the early detection programs offered by statutory health insurance providers.
Starting at age 50, a so-called Hemoccult test (also known as the guaiac test) is performed annually, and health insurance plans cover the cost.
This test provides a rough indication of whether further examinations are necessary. Starting at age 55, a colonoscopy is then performed every 10 years.
If someone is unable or unwilling to undergo a colonoscopy, a Hemoccult test can be performed every two years instead. In addition, the doctor may also perform a digital rectal exam.
In some cases, doctors recommend undergoing colorectal cancer screening even before the age of 50. This applies, for example, to people at high risk.
These include, for example, people with first-degree relatives who have had colorectal cancer.
These individuals should begin early screening ten years before the relative’s first diagnosis, but no later than age 40 or 45. It’s a good idea to check with your health insurance provider beforehand to see if they will cover the costs.
In addition, there are hereditary conditions that increase the risk of colorectal cancer. These include, for example, Peutz-Jeghers syndrome, which is characterized by an increased occurrence of polyps in the stomach and intestines.
People with these conditions receive a personalized colorectal cancer screening plan from their doctor. The doctor creates this plan in accordance with the guidelines for diagnosing genetic predisposition to cancer issued by the German Medical Association.
In this test, doctors examine the patient’s stool for occult—that is, invisible—blood. To do this, the patient uses a spatula to apply stool to a paper strip on three separate days.
The doctor can then evaluate the samples themselves or send them to a laboratory. A positive test result indicates traces of blood in the stool. This test can detect about half of all colon cancers.
However, a positive test does not necessarily mean that the person has colon cancer. The traces of occult blood may also have other causes.
Hemorrhoids or bleeding gums can cause a positive test result.
The following factors can also lead to a false-positive test result:
- Raw meat
- Certain vegetables
- Various medications, such as acetylsalicylic acid (ASA) or iron supplements
Therefore, if the test is positive, a colonoscopy must be performed afterward. This will help determine the exact cause of the occult blood in the stool.
The immunological stool test (also known as iFOBT) is also offered every two years.
The digital rectal exam, also known as DRE, is used to detect changes in the rectum. During the exam, the primary care physician feels the rectum with a finger.
During the exam, the patient lies on their left side on an examination table. Alternatively, they may lean forward with their upper body.
The doctor then gently inserts a gloved finger into the rectum using lubricant. He or she then feels the rectal wall for any abnormalities. The entire examination takes about one minute.
It can be life-saving in the case of rectal cancer. Therefore, you should not skip this screening.
A colonoscopy is the most important and safest method for detecting colon cancer.
During the procedure, doctors insert a device called an endoscope into the colon through the anus. The patient receives only mild sedation for this.
The endoscope is a flexible tube equipped with a light source and a camera at the tip. Through the camera, the doctor can view images of the inside of the colon and examine it for abnormalities.
The doctor looks primarily for polyps, as these can develop into colorectal cancer over the years. If the doctor discovers polyps, they are removed directly during the colonoscopy. The doctor can also take tissue samples from areas of the mucous membrane that appear abnormal during the procedure.
Overall, a colonoscopy carries only a few risks. The endoscope may cause injury to the intestinal wall; however, this complication is rare. The benefits of a colonoscopy outweigh the risks, as it enables the early detection of colon cancer.
Patients who undergo a colonoscopy are entitled to another colonoscopy every ten years.
Overall, a colonoscopy carries only a few risks. The endoscope may cause injury to the intestinal wall. However, this complication is rare. The benefits of a colonoscopy outweigh the risks, as it enables the early detection of colorectal cancer.
Colonic polyps are considered the most common precursor to colorectal cancer. They develop from cells in the intestinal mucosa, often remain benign for a long time, but can become malignant over time.
Since many people develop colorectal cancer without realizing it, early removal of these growths is crucial.
During a colonoscopy, precancerous lesions can be removed immediately. This effectively reduces the risk of developing colorectal cancer.
It is especially important to undergo screening exams. However, a healthy lifestyle can also be beneficial.
You should not smoke and should drink alcohol only in moderation. A diet low in meat and high in fiber, with plenty of fruits and vegetables, is also helpful.
This also applies to getting enough physical activity. These measures help stool move through the digestive tract more quickly.
This means that any toxins that may be present in food have less time to damage the intestinal lining.
Being overweight and having diabetes can also increase the risk of colorectal cancer due to elevated insulin levels. Therefore, people in these high-risk groups should definitely take advantage of screening programs.
Statutory colorectal cancer screening in Germany is clearly regulated. Insured individuals aged 50 and older receive the following tests for the early detection of colorectal cancer from their health insurance provider:
- Stool test
- Immunological stool test for early detection
- Colonoscopy (from age 55)
- Option for earlier screening if individuals are at higher risk for colorectal cancer or have a family history of the disease
Your doctor will advise you individually on which measures are appropriate and which are fully covered by statutory health insurance.
The immunological stool test is considered very reliable, especially when used regularly.
Many guidelines recommend undergoing the screening starting at age 50 or, at the latest, at age 55.
Yes, all standard colorectal cancer screening measures are covered by your health insurance.
If you notice blood in your stool, unexplained abdominal discomfort, or abnormal stool test results, you should always undergo a colonoscopy.
