Prevention (or precaution) are all measures that:
- Avoid the occurrence of diseases
- Delay the onset of an illness
- Mitigate the consequences of a disease
The aim of prevention is to reduce or completely eliminate the factors that trigger the development of a disease.
Through prevention, doctors can identify individual risk factors such as genetic predisposition, lifestyle and living conditions .
Doctors often use the term prophylaxis, particularly in the area of prevention and diagnosis of dental diseases.
As society is getting older, the incidence of common diseases is also increasing.
Important common diseases that are of particular importance in prevention and screening and occur especially in old age are
In addition to the health benefits, the aim of prevention and screening is to reduce costs for the healthcare system.
One in two adults is already overweight and one in five is obese @ Christian Delbert /AdobeStock
Prevention can be divided into different levels of prevention based on the patient's current state of health.
1. primary prevention are measures for risk protection (precaution) in healthy people. This means that a health disorder or disease does not yet exist.
2. secondary prevention includes diagnostic measures that detect diseases at an early stage so that patients can be treated.
3. measures to prevent relapses and reduce consequential damage are part of tertiary prevention.
4. quaternary prevention aims to prevent the excessive use of medication and unnecessary medical measures in order to prevent damage to health.
Prevention: primary prevention
Primary prevention is aimed at every healthy person and people who belong to a certain risk group.
Primary prevention involves measures that are intended to maintain health or prevent the development of diseases. Primary prevention starts before an illness breaks out and health damage occurs or health-damaging behavior begins.
Doctors analyze risk factors and possible causes (also using diagnostic methods) that could have a negative impact on health.
Thetarget group for primary prevention is healthy people without symptoms.
Examples of primary prevention measures are
- Health promotion and training (nutrition, exercise, stress management, back-friendly working)
- Addiction prevention (smoking and alcohol)
- Vaccinations
- Contraception and prenatal care as part of diagnostics
- Accident prevention and occupational safety measures
- Avoidance of infections through hygiene measures
Prevention: secondary prevention
Secondary prevention includes diagnostic measures that detect diseases, damage and unhealthy behavior at an early stage. The progression of the disease can thus be prevented.
Secondary prevention is aimed at people who are at an early stage and do not yet have any symptoms. They are therefore unaware of their disease. They are usually healthy people who become ill as a result of the diagnosis.
Thetarget group of secondary prevention are sick people (in the early stages) without symptoms.
Examples of diagnostics in secondary prevention are
Mammography screening is currently the most reliable method for the early detection of breast cancer @ Gorodenkoff /AdobeStock
Prevention: tertiary prevention
Tertiary prevention includes measures for a disease that has already broken out, which prevent relapses andreduce or avoid consequential damage (complications).
The patient should recognize the health-damaging behaviour (using diagnostic methods). Doctors initiate measures to prevent secondary illnesses, relapses (recurrences) or a worsening of a chronic illness.
Tertiary prevention is aimed at patients who are already ill and have started treatment. This group also includes chronically ill patients and people undergoing or about to undergo rehabilitation.
Thetarget group for tertiary prevention is patients with symptoms.
Examples of tertiary prevention measures are
- Rehabilitation and cures (e.g. rehabilitation measures after a stroke)
- Measures to prevent kidney failure as a result of diabetes mellitus
Prevention: quaternary prevention
The aim of quaternary prevention is to prevent excessive use of medication and unnecessary medical measures. Incorrect or unnecessary measures and inappropriate medication can lead to damage to health. As part of quaternary prevention, doctors often look for alternative healing methods.
Thetarget group of quaternary prevention is healthy people with symptoms.
Examples of quaternary prevention measures are
- Avoiding polypharmacy(taking numerous medications that have an increased risk of interactions and adverse effects)
- Avoidance of unnecessary diagnostics (e.g. consequences of false-positive or false-negative tests in systematic cancer screening)
Early detection examinations (screening examinations) play an important role in prevention (screening).
At this stage, the treatment and healing options are better if doctors recognize undesirable developments, diseases and disorders at an early stage.
The aim of early detection examinations is to achieve a cure through timely treatment and to prevent or alleviate consequential damage.
In adults, the aim of a preventive or early detection examination is to detect any existing illness in its early stages.
In children, the main focus is on developmental delays or developmental risks. Screening allows the necessary measures for early treatment and early intervention to be initiated in good time.
Doctors combine the preventive and early detection examinations into a preventive program. They are suitable for newborns and children, adolescents, women and men.
The best-known preventive and early detection examinations include
- Antenatal care
- Newborn screening and
- "U-examinations" for children
Below you will find the most important statutory preventive and early detection examinations.
The health check-up for the early detection of diseases, which is often also called a health check-up, consists of various diagnostic measures.
The examinations included in this preventive health check-up include a physical examination, including
- Blood pressure measurement
- examination of the urine for blood, protein and glucose (sugar) and
- Determination of cholesterol and glucose in the blood
The health check-up is used for the early detection of various diseases such as cardiovascular and kidney diseases, diabetes and cancer.
In Germany, there are several cancer screening examinations for men and women of different ages.
Statutory cancer screening for women
The early detection of cancer of the reproductive organs for women from the age of 20 includes
- Medical history interview with questions about symptoms, bleeding disorders and discharge,
- Examination of the cervix
- Collection of examination material from the cervix and cervical smear (cancer smear)
- Cytological examination (Pap test)
- Gynecological palpation
- Final consultation
From the age of 30, the gynecologist will ask about changes and complaints in the breast during the check-up. An examination and palpation of the breast and lymph nodes, including instructions for self-examination, are also carried out.
From the age of 50, an X-ray examination of both breasts is also carried out as part of the mammography screening. Patients undergo this screening every two years until the end of their 70th year.
From the age of 35, skin cancer screening is carried out every two years .
Doctors examine the skin:
- Changes and complaints of the skin
- Examination of the hairy head
- Examination of body skin folds (armpits, groin, gluteal cleft, finger and toe gaps, underbust area, navel)
From the age of 50, patients can have their rectum and colon examined as part of early detection. The doctor examines hidden blood in the stool (annually up to the age of 54). From the age of 55, patients can have two colonoscopies at ten-year intervals.
Thecolonoscopyis performed on an outpatient basis @ Kzenon /AdobeStock
Statutory cancer screening for men
For men, statutory cancer screening begins from the age of 35 with the early detection of skin cancer. These are recommended every two years.
In a medical history interview, the doctor will ask about changes and complaints in the skin.
The diagnosis includes
- Examination of the entire skin all over the body
- Examination of the hairy head and
- Examination of the body skin folds (armpits, groin, gluteal cleft, spaces between fingers and toes, underbust area, navel)
From the age of 45, statutory screening provides for the early detection (screening) of cancers of the reproductive organs. This is done by inspecting and palpating the external genital organs. The focus is on palpation of the prostate and lymph nodes.
The early detection of cancer of the rectum and colon begins from the age of 50 with the diagnosis of blood in the stool. Patients can have this carried out annually up to the age of 54.
From the age of 55, you can have two colonoscopies at ten-year intervals.
There is a screening program for newborns, children and adolescents that serves the prevention and early detection of malformations and developmental disorders. These so-called U-examinations begin at birth and end at the age of around 17.
The first screening, the U1 newborn examination, takes place immediately after birth and includes the following diagnostic tests
- skin color
- breathing
- muscle activity
- heartbeat and
- reflexes
- Fontanelle, eyes, nose, mouth, spine, extremities and joints
The extended newborn screening on the 2nd or 3rd day of life is used for the early detection of congenital metabolic defects and endocrine disorders.
With newborn hearing screening up to the 3rd day of life, doctors can detect bilateral hearing disorders from a hearing loss of 35 decibels. The U2 screening takes place on the 3rd to 10th day of life and includes an examination of organs, sensory organs and reflexes.
The U3 screening takes place in the 4th to 5th week of life. Here, doctors check the age-appropriate development of reflexes, motor skills, weight and reactions.
The doctor examines organs, drinking, digestion and sleeping behavior as well as the hip joints for hip joint dysplasia and hip joint dislocation.
The U4 screening in the 3rd to 4th month of life and the U5 screening in the 6th to 7th month of life include an examination of age-appropriate development.
The focus is also on
- Mobility of the infant
- organs
- sensory organs
- sexual organs and
- skin
- Examination of growth, motor skills and nervous system
During the U6 screening (10th-12th month of life), mental development is checked for the first time in addition to the examination of the sensory organs and the ability to move.
The U7 screening (21-24 months) focuses on language development, fine motor skills and body control.
The U7a screening (34-36 months of age) covers
- Further speech development
- Behavioral abnormalities such as sleep disorders, visual disturbances and
- Other abnormalities
The U8 screening (46-48 months of age) includes
Intensive examination of the development of speech, pronunciation and behavior, examination of mobility and coordination skills, reflexes, muscle strength and dental status
From birth to the age of 18, 11 check-ups are free for children @ Robert Kneschke /AdobeStock
The aim of the U9 screening between the 60th and 90th month of life is to detect the following disorders before the child starts school:
- Disorders in motor skills
- Disorders in speech development
- Hearing and vision disorders
The next regular check-up takes place at the age of 13 to 14 with the J1 check-up. In addition to checking vaccination status, doctors look for physical and mental abnormalities and behavior that could pose a risk to health.
The J2 screening at the age of 16 to 17 serves to prevent:
- Puberty and sexual disorders
- Postural disorders
- Goitre formation
- Diabetes risk
- Socialization and behavioural disorders
Initial advice is also given on career choices.
There are also dental check-ups for children between the ages of 30 and 27 months and 6 and 18 years.
These include early dental check-ups for tooth, mouth and jaw diseases and advice on oral hygiene and nutrition.
The term diagnostics itself means finding a diagnosis, in which findings (symptoms) are assigned to a specific disease.
The diagnosis is the determination of the disease, whereby a presumption or identification of the cause of the disease is also part of the diagnosis. The aim of diagnostics is to make a diagnosis.
Diagnostic methods are
- Taking a medical history
- physical examination
- Laboratory tests or
- Imaging procedures
It is not always possible to make a clear diagnosis. Further examination methods are then required.
For this reason, there are other terms used in diagnostics in addition to the term diagnosis:
- Exclusion diagnosis
- Differential diagnosis (differential diagnosis) and
- suspected diagnosis and working diagnosis
Diagnostics: Exclusion diagnosis
In a diagnosis of exclusion, doctors exclude other possible causes of a disease through further examinations. This leaves only one explanation for the cause of the symptoms.
Diagnosis: Differential diagnosis
If there are several possible diagnoses or explanations for a particular set of symptoms, these diagnoses are called differential diagnoses. Doctors use differential diagnosis to try to differentiate between the possible causes and reduce the number of possible diagnoses.
Suspected and working diagnosis
If doctors cannot make a definite diagnosis using diagnostics and differential diagnostics, they make an assumption about the symptoms.
The doctor then speaks of a suspected diagnosis or a working diagnosis if he or she initiates treatment on this basis.
Preventive care specialists come from different areas of medicine. For example, a cardiologist can specialize in disease prevention just as much as a dermatologist or gynaecologist.
Many nutritionists also work in the field of prevention. After studying medicine, they have to complete further training to become a specialist.
In the field of prevention, doctors work closely with experts from other medical professions such as dieticians or physiotherapists.
You can find your specialist for prevention and diagnostics here and contact them directly!
