Prevention & Screening | Find Screening Specialists

Prevention (or precautionary measures) refers to all measures that:

• Prevent the onset of diseases
• Delay the onset of a disease
• Mitigate the consequences of a disease

The goal 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.

Medical professionals also frequently use the term “prophylaxis,” particularly in the context of preventing and diagnosing dental diseases.

As society continues to age, the prevalence of common diseases is also increasing.

Major common diseases that are of particular importance in prevention and screening—and that occur especially in older adults—include:

• Arteriosclerosis
• Diabetes (type 2 diabetes mellitus)
• Obesity
• Osteoarthritis
• Heart failure
• Osteoporosis and
• Malignant tumors (cancer)

In addition to the health benefits, prevention and early detection aim to reduce costs for the healthcare system.

Already, one in two adults is overweight and one in five is obese @ Christian Delbert /AdobeStock

Prevention can be divided into different levels based on the patient’s current state of health.

1. Primary prevention consists of measures to protect healthy individuals from risk (for preventive care). This means that a health problem or disease is not yet present.

2. Secondary prevention includes diagnostic measures that detect diseases early so that patients can receive treatment.

3. Measures to prevent relapses and reduce secondary complications fall under tertiary prevention.

4. Quaternary prevention aims to prevent the excessive use of medications and unnecessary medical interventions in order to avoid harm to health.

Prevention: Primary Prevention

This preventive care is intended for all healthy individuals and those who belong to a specific risk group.

Primary prevention involves measures designed to maintain health or prevent the development of diseases. Primary prevention begins before a disease breaks out, before health damage occurs, or before health-damaging behavior begins.

Doctors analyze risk factors and possible causes (including through diagnostic methods) that could have a negative impact on health.

The target group for primary prevention is healthy individuals without symptoms.

Examples of primary prevention measures include:

• Health promotion and education (nutrition, physical activity, stress management, back-friendly work practices)
• Addiction prevention (smoking and alcohol)
• Vaccinations
• Contraception and prenatal care as part of diagnostic services
• Accident prevention and occupational safety measures
• Prevention of infections through hygiene measures

Prevention: Secondary Prevention

Secondary prevention involves diagnostic measures that detect diseases, injuries, and health-damaging behaviors at an early stage. This helps prevent the disease from progressing.

Secondary prevention is aimed at individuals who are in the early stages of a condition and do not yet have any symptoms. They are therefore unaware of their condition. These are mostly healthy people who, as a result of diagnostic testing, are identified as having a condition.

The target group for secondary prevention is people with disease (in the early stages) who have no symptoms.

Examples of diagnostic procedures in secondary prevention include:

• Examinations for early disease detection (e.g., screening for breast cancer or colorectal cancer, early cancer detection, newborn screening, blood pressure screening)
• Health check-ups (medical examinations)
• Identification of adolescents who have been exposed to drugs in order to prevent further use or addiction

Mammography screening is currently the most reliable method for the early detection of breast cancer @ Gorodenkoff /AdobeStock

Prevention: Tertiary Prevention

Tertiary prevention involves measures taken once a disease has already developed to prevent relapses and reduce or avoid secondary damage (complications).

The patient should recognize behaviors that are harmful to their health (using diagnostic methods). Doctors initiate measures designed to prevent secondary conditions, relapses (recurrences), or the worsening of a chronic condition.

Tertiary prevention is aimed at patients who are already ill and have begun treatment. This group also includes chronically ill patients and individuals undergoing or preparing for rehabilitation.

The target group for tertiary prevention consists of patients with symptoms.

Examples of measures in tertiary prevention include:

• Rehabilitation and therapeutic stays (e.g., rehabilitation measures following a stroke)
• Measures to prevent kidney failure resulting from diabetes mellitus

Prevention: Quaternary Prevention

The goal of quaternary prevention is to prevent the excessive use of medications and unnecessary medical interventions. Incorrect or unnecessary interventions and inappropriate medications can lead to health complications. As part of quaternary prevention, doctors often seek out alternative treatment methods.

The target group for quaternary prevention is healthy individuals with symptoms.

Examples of measures in quaternary prevention include:

• Avoiding polypharmacy (taking numerous medications, which carries an increased risk of interactions and adverse effects)
• Avoiding unnecessary diagnostic tests (e.g., the consequences of false-positive or false-negative test results in systematic cancer screening)

Early detection screenings (preventive screenings) play an important role in the context of prevention (preventive care).

At this stage, treatment and cure rates are higher when doctors detect abnormalities, diseases, and disorders early on.

The goal of early detection examinations is to achieve a cure through timely treatment and to prevent or alleviate subsequent damage.

For adults, the goal of a preventive or early detection examination is to detect any potential disease in its early stages.

For children, the focus is primarily on developmental delays or risks to development. Through preventive care, necessary measures for early treatment and early intervention can be initiated in a timely manner.

Doctors organize preventive and early detection screenings into a preventive care program. They are suitable for newborns, children, adolescents, women, and men.

Among the best-known preventive or early detection screenings are:

• Prenatal care
• Newborn screening and
• “U-exams” for children

Below you will find the most important legally mandated preventive and early detection screenings.

The health examination for the early detection of diseases, often referred to as a health check-up, consists of various diagnostic measures.

The diagnostic tests included in this preventive care program consist of a physical examination, including:

• Blood pressure measurement
• Urinalysis to check for blood, protein, and glucose (sugar), as well as
• Measurement of cholesterol and glucose in the blood

The health screening is designed to detect various diseases at an early stage, such as cardiovascular and kidney diseases, as well as diabetes and cancer.

In Germany, there are several cancer screening tests available for men and women of various ages.

Statutory Cancer Screening for Women

For the early detection of cancers of the reproductive organs in women aged 20 and older, the following are included:

• A medical history interview with questions about symptoms, abnormal bleeding, and vaginal discharge,
• Examination of the cervix
• Collection of tissue samples from the cervix (Pap smear)
• Cytological examination (Pap test)
• Gynecological pelvic exam
• Final consultation

Starting at age 30, the gynecologist will ask about any changes or symptoms in the breasts during the checkup. An examination and palpation of the breasts and lymph nodes, including instructions for self-examination, will also be performed.

Starting at age 50, an X-ray examination of both breasts is also performed as part of mammography screening. Patients undergo these screenings every two years until the end of their 70th year.

Starting at age 35, skin cancer screening is performed every two years.

During these exams, doctors check for:

• Changes and symptoms affecting the skin
• Examination of the scalp
• Examination of skin folds (armpits, groin, buttocks, spaces between fingers and toes, under the breasts, navel)

Starting at age 50, patients can have their rectum and colon examined as part of early detection screening. The doctor checks for hidden blood in the stool (annually until age 54). Starting at age 55, patients can undergo two colonoscopies at ten-year intervals.

The colonoscopy is performed on an outpatient basis @ Kzenon /AdobeStock

Statutory Cancer Screening for Men

For men, statutory cancer screening begins at age 35 with early detection of skin cancer. These screenings are recommended every two years.

During a medical history interview, the doctor asks about changes and symptoms affecting the skin.

The diagnostic process includes:

• Examination of the entire skin over the whole body
• Examination of the scalp and
• Examination of the skin folds (armpits, groin, buttocks, spaces between fingers and toes, under the breasts, and the navel)

Starting at age 45, the statutory screening program provides for the early detection (screening) of cancers of the reproductive organs. This is performed through visual inspection and palpation of the external genitalia. The focus is on digital rectal examination of the prostate and palpation of the lymph nodes.

Early detection of cancers of the rectum and colon begins at age 50 with a fecal occult blood test. Patients can have this test performed annually until age 54.

Starting at age 55, you can undergo two colonoscopies at ten-year intervals.

There is a preventive care program for newborns, children, and adolescents designed to prevent and detect developmental abnormalities and disorders early. These so-called U-examinations begin at birth and continue until the age of about 17.

The first checkup, the U1 newborn examination, takes place immediately after birth and includes the following diagnostic checks:

• skin color
• Breathing
• Muscle activity
• heart rate, and
• reflexes
• Fontanelle, eyes, nose, mouth, spine, extremities, and joints

The expanded newborn screening on the 2nd or 3rd day of life is used for the early detection of congenital metabolic disorders and endocrine disorders.

Newborn hearing screening, performed by the 3rd day of life, allows doctors to detect bilateral hearing impairments starting at a hearing loss of 35 decibels. The U2 checkup takes place between the 3rd and 10th day of life and includes an examination of organs, sensory organs, and reflexes.

The U3 checkup takes place during the 4th to 5th week of life. During this visit, doctors assess age-appropriate development of reflexes, motor skills, weight, and responses.

The doctor examines the baby’s organs, feeding, digestive, and sleeping patterns, as well as the hip joints for hip dysplasia and hip dislocation.

The U4 checkup, which takes place between the 3rd and 4th months of life, and the U5 checkup, which takes place between the 6th and 7th months of life, involve an assessment of age-appropriate development.

Other key areas of focus include:

•  The infant’s mobility
• Organs
• Sensory organs
• Genital organs, and
• Skin
• Examination of Growth, Motor Skills, and the Nervous System

During the U6 checkup (10th–12th month of life), in addition to examining the sensory organs and motor skills, mental development is assessed for the first time.

The U7 checkup (21–24 months of age) focuses on language development, fine motor skills, and body control.

The U7a checkup (34–36 months of age) includes:

• Further language development
• Behavioral issues such as sleep disturbances, vision problems, and
• Other abnormalities

The U8 checkup (46th–48th month of life) includes:

A thorough assessment of language development, pronunciation, and behavior; evaluation of mobility, coordination, reflexes, muscle strength, and dental health

Children are entitled to 11 free preventive checkups from birth through age 18 @ Robert Kneschke /AdobeStock

The goal of the U9 checkup between the 60th and 90th month of life is to identify the following disorders before the child starts school:

• Motor skill disorders
• Speech development disorders 
• Hearing and vision impairments

The next regular preventive checkup takes place between the ages of 13 and 14 with the J1 checkup. In addition to checking vaccination status, doctors look for physical and psychological abnormalities and behaviors that pose a health risk.

The J2 checkup, conducted between the ages of 16 and 17, is designed to prevent:

• Pubertal and sexual disorders
• Postural problems
• Goiter formation
• Risk of diabetes
• Socialization and behavioral disorders 

In addition, an initial career counseling session is provided.

In addition, there are preventive dental checkups for children, which take place between the ages of 30 and 27 months and from age 6 to 18. 

These include, among other things, early-detection dental examinations for dental, oral, and jaw diseases, as well as counseling on oral hygiene and nutrition.

The term “diagnostics” refers to the process of establishing a diagnosis, in which findings (symptoms) are linked to a specific disease. 

A diagnosis is the determination of a disease, and this also includes hypothesizing or identifying the cause of the disease. The goal of diagnostics is to establish a diagnosis.

Methods of diagnostics include:

• Medical history
• Physical examination
• Laboratory tests, or
• Imaging procedures

It is not always possible to make a definitive diagnosis. In such cases, additional diagnostic methods are required. 

For this reason, in addition to the term “diagnosis,” there are other terms used in diagnostics: 

• Exclusion diagnosis
• Differential diagnosis (differential diagnostic process) and 
• Presumptive and working diagnoses

Diagnostics: Exclusion diagnosis

In exclusion diagnosis, doctors rule out other possible causes of a disease through further examinations. As a result, only one explanation for the cause of the symptoms remains.

Diagnostics: Differential Diagnosis

If there are several possible diagnoses or explanations for a specific set of symptoms, these diagnoses are called differential diagnoses. Through differential diagnosis, doctors attempt to distinguish between the possible causes and reduce the number of possible diagnoses.

Preliminary and Working Diagnosis

If doctors cannot make a definitive diagnosis through diagnostic testing and differential diagnosis, they offer a hypothesis regarding the symptoms. 

The doctor refers to this as a presumptive diagnosis or working diagnosis when he or she initiates treatment based on this assessment.

Preventive care specialists come from various fields of medicine. For example, a cardiologist may specialize in disease prevention just as much as a dermatologist or a gynecologist. 

Likewise, many nutritionists work in the field of prevention. After completing their medical studies, they must undergo further training to become board-certified specialists. 

In the field of prevention, physicians work closely with experts from other medical professions, such as dietitians and physical therapists.

Here you can find your specialist in prevention and diagnostics and contact them directly!