From mammography to colonoscopy to skin screening – we present the most common checks and tell you what is really needed and what you can do to save yourself.
If doctors, health insurances and health ministers promote the same thing, then it must be significant: With regular campaigns, we are asked to take advantage of the offers for the early detection of cancer to cardiovascular diseases. But what benefits do these checks really bring?
We looked at the most popular offers, both those that are reimbursed by the statutory health insurance funds and those that patients have to pay to the doctor himself. Here you can see at a glance which pension benefits you should definitely use, which are recommended and which you can do without.
These tests have to be
X-ray examination of the breast (mammography)
Reason: every two years, women between 50 and 69 are asked by letter for a free chest x-ray check. This age is considered the main risk range for breast cancer, the most common tumour in women. Of the invitees, just over half make the appointment.
Procedure: In mammography, the breasts are pressed perpendicularly from above and diagonally laterally between Plexiglas plates and x-rayed. In the picture, the radiologist can recognize even those breast cancer foci that cannot be touched yet. How well this works, however, depends strongly on the composition of the breast.
Assessment: The procedure helps in many cases to detect cancer so early that affected women can be cured. 78 out of 100 detected tumours show no lymph node involvement but mammography also has weaknesses. In dense breast tissue, nodes on the X-ray image can hide behind a curtain: around 60 out of 100 malignant tumours remain undetected in this case (moreover, the risk of developing breast cancer is five times higher with high breast density than with loose tissue). Younger women – but also every third person over 50 – so fall through the mesh of screening.
Alternatives: For dense, i.e., breasts rich in breasts, a supplementary high-resolution chest ultrasound is useful. This mamma sonography costs between 35 and 75 euros (statutory health insurance pay only in case of abnormal findings or family risk). As a sole method, the ultrasound is not suitable because it does not reliably detect precursors of breast cancer and in turn, has problems with fatty breasts. A more powerful alternative to the X-ray check and breast ultrasound is magnetic resonance imaging (MRI). With over 95 percent hit rate, breast MRI delivers the best results. Unfortunately, the health insurances pay this 500-euro screening for early detection only for women with a very high risk of breast cancer.
Reflection of the colon (colonoscopy)
Reason: From 55 on, insured persons are entitled to two colonoscopies every ten years.
Procedure: Using a lubricant, the gastrointestinal specialist (gastroenterologist) pushes a flexible tube to the cecum. When withdrawn, the camera built into the endoscope provides images of the intestinal mucous membrane on which existing cancer precursors (polyps) are recognizable. 90 percent of all colon carcinomas arise from such benign precursors that grow very slowly. Tongs can be used to remove suspicious tissue. Thanks to Dämmerspritze the unpleasant procedure is overslept.
Assessment: Absolutely go! According to a US long-term study, colorectal cancer mortality among those examined drops by 53 percent. Complications, such as bleeding, are rare. They only affect two to three out of 1000 people examined.
Alternatives: From the age of 50, women and men can have their stool checked for blood every one to two years. If this pre-test strikes, the colonoscopy is searched for the causes. The virtual colonoscopy by CT (for private payers) is more pleasant but is considered less reliable.
Good chance of survival in cancer: what we can learn from the Danes
Reason: As part of the annual cancer screening for women over the age of 20, the gynaecologist will check if cervical cells show signs of inflammation or early signs of cancer. This is called a Pap test.
Procedure: The doctor takes with spatula or small brush smears from the cervix and cervical canal. The mucosal cells are controlled under the microscope. Depending on the test classification from I (normal) to V (serious), the Pap test is supplemented with an HPV test, repeated after a few months, or a tiny tissue sample is taken.
Assessment: A very useful test, which shows a regular accuracy of 80 to 90 percent. This is also confirmed by the long-term results: Since the introduction of screening in the early 1970s, the cervix cancer rate in Germany has fallen by 90 percent among the women who participated each year.
Alternatives: At the earliest starting from 2018 women from 35 onwards should only get the Pap smear every three years, in combination with the HPV test. In doing so, the doctor checks whether human papillomaviruses can be detected in the vaginal area – i.e. the pathogens that can trigger cancer over many years to decades.