From the age of 50, there are invitations to early detection
In Germany, around 60,000 people develop colon cancer every year, and 25,000 die from it. Since 2019, people with statutory health insurance in Germany have been able to take advantage of an improved screening program so that colorectal cancer is detected at an early stage. It includes several examinations at different time intervals. Between the ages of 50 and 65, people with statutory health insurance receive a letter from their health insurance company every five years inviting them to take part in free bowel cancer screening services. The letter contains detailed information on the investigations, data protection, objection rights and program evaluations. Previously there were only invitations of this kind for mammography (early detection of breast cancer). Experience shows that invitations can increase willingness to participate.
Tipp: Participation in the early detection of colorectal cancer is also possible without an invitation – provided you are of the right age. Call your doctor. The health insurance comparison by Stiftung Warentest shows what the statutory health insurance companies offer in terms of additional cancer screening tests for women.
Colonoscopy for men over 50 possible
The most important examination as part of the screening program is the colonoscopy – known in technical terms as a colonoscopy. Men can now claim them from the age of 50 at health insurance costs. The reason: They develop colorectal cancer more frequently and, above all, earlier than women. According to the DKFZ, it affects 46 out of 100,000 men, regardless of age, but only 28 out of 100,000 women. Gender differences in the precancerous lesions were even stronger. For women, the official starting age for a colonoscopy is 55 years.
Mirroring reduces risk of death by 70 percent
The colonoscopy is considered to be complex, but the most reliable method. Specialists such as gastroenterologists use a tube endoscope to examine the colon for tissue changes and can directly remove cancer precursors such as polyps. The results of a long-term observation by the University of Pennsylvania show that an endoscopy significantly reduces the risk of dying from colon cancer in the following ten years: the endoscopy reduces the risk by almost 70 percent.
Those who get in early are entitled to two reflections
Both sexes can have the examination carried out a second time at the health insurer’s expense – but only after a minimum interval of ten years, because colorectal cancer usually develops slowly. For example, anyone who wants to be examined for the first time at the age of 65 or later is only entitled to one screening colonoscopy.
Tipp: If you have a family history or unclear symptoms, you can have a colonoscopy at the health insurance company’s expense earlier – for example at the age of 30. The prerequisite: a doctor must consider the examination to be necessary. You are entitled to a colonoscopy for clarification at any time.
Stool test remains faster alternative
There is also a second early detection method funded by law – the immunological stool test (iFOBT). It has replaced the previous chemical stool test since 2017. In the immunological test, a stool sample is analyzed for invisible traces of blood by means of antibody detection – possible indication of a tumor. Men and women between the ages of 50 and 54 can have it every year, provided they have not had a colonoscopy. People over 55 are entitled to it every other year – if no colonoscopy was done during that time. Researchers at the German Cancer Research Center complain that only 10 percent of the men and 20 percent of the women who were contacted carried out the stool test. Apparently taking part is currently too complicated. The stool test must first be picked up from the doctor, then carried out at home and brought back to the practice. The researchers suggest sending the stool test to those entitled to it by post in the future.
Important to know: General practitioners and certain specialists such as gynaecologists, urologists or dermatologists issue the stool test. If hemoglobin is detected in the stool, the suspected cancer can only be investigated by means of a colonoscopy.
take a counseling session
Insured persons can also get detailed advice about the preventive care program from their doctor at health insurance costs. All panel doctors who carry out early detection of colorectal cancer or health examinations may offer one-time detailed advice on the aim and purpose of the screening program.
Tipp: The Federal Joint Committee is making new information brochures available on the offer – for women and for men.
Praise and criticism from professional societies for cancer screening
The German specialist associations of gastroenterologists see the introduction of screening as a significant step forward, but would have liked more detailed regulations in some areas. The German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS), to start early detection in men from the age of 45. An earlier start of screening should also be established for relatives of colorectal cancer patients, as they have an increased risk of cancer.
Family risk possible
Genetic defects or a family history can increase the risk of colon cancer. scientist of DKFZ assume that about every fourth colorectal cancer has a family background. The extent of the increase in risk depends on various factors:
- First degree relatives. If parents, siblings or children develop colon cancer, their own risk of colon cancer is about twice as high as for people without a family history.
- Second degree relatives. If grandparents, uncles, aunts or grandchildren have colon cancer, their own risk of colon cancer is also considered to be increased – albeit to a lesser extent than in first-degree relatives.
- Number of affected relatives. The more relatives who have already been diagnosed with colon cancer, the higher the risk of developing it themselves. It is considered four-fold increased when two or more first-degree relatives have had colorectal cancer.
- Age of relatives at diagnosis. The younger the relatives were when they were diagnosed with colon cancer, the higher their own risk of colon cancer. The risk increase is considered to be 1.8-fold if relatives over the age of 60 have colorectal cancer. The risk increases by up to 3.6 times if relatives were younger than 50 at the time of diagnosis.
- Precancerous lesions in relatives. Your own colon cancer risk also increases if relatives had colon cancer precursors (adenomas). According to the DKFZ, there are fewer studies on this aspect than on family predispositions. It is assumed that one’s own risk for adenomas in first-degree relatives is also about twice as high.
Smoking, drinking and being overweight also increase the risk
Some lifestyle habits can also promote colon cancer. These include smoking and drinking alcohol regularly, frequent consumption of large portions of red meat such as beef steak and pork chops, a lifestyle with little exercise and a lot of sitting. Being overweight can also promote colon cancer.