Preventive Health Screening

What are Preventive Health Screenings?

Preventive health screenings are medical examinations that serve the early detection of diseases. In addition, risk factors that promote the development of diseases are also detected. Therefore, the aim of these examinations is to detect diseases at an early stage and to eliminate possible risk factors before they lead to disease. Screening examinations belong in the field of preventive health care. They are offered as voluntary services and are intended primarily for people who are still symptom-free and have no symptoms of illness.

Nowadays, there are many different preventive examinations, about which information is provided either by the treating physician or through brochures or personal invitation letters.

What are IGeL Services?

"IGeL" services are individual health services and refer to examinations and medical measures whose costs are not covered by health insurance and which you have to pay for yourself. These medical services are mainly used for prevention and disease care, but their benefits have not yet been sufficiently proven. The "IGeL" services include, for example, glaucoma screening, i.e., the determination of intraocular pressure as part of the early detection of glaucoma and the determination of the PSA value as part of prostate cancer screening.

Which Preventive Examinations are Useful?

In Germany, there are many preventive examinations, which vary according to age and gender. For adults, the following are offered:

First, there are dental checkups. These are recommended once every six months starting at the age of 18 and include a detailed examination of the teeth by the dentist.

Second, as part of cancer screening, skin cancer screening is offered every two years for adults 35 years and older. The aim of this screening is the early detection of black skin cancer ("malignant melanoma") and light skin cancer ("basal cell and squamous cell carcinoma") and the prevention of the progression of these diseases. The following aspects are integrated into this examination procedure: a detailed anamnesis interview regarding changes of, e.g., moles, etc., the examination of the skin on the entire body, and the communication of the result with corresponding advice on further measures.

Another important preventive measure is the so-called "checkup," a medical health examination recommended every three years for insured persons over 35. The "checkup" involves early detection of risk factors for diabetes mellitus or cardiovascular diseases, such as high blood pressure. During a comprehensive medical history review with the general practitioner, the existing risk factors are recorded, followed by a physical examination and blood sampling, and urine sampling for laboratory examination of values such as cholesterol and glucose. Following the evaluation of the examinations, a consultative review takes place to identify ways to reduce the existing risk factors.

For men over the age of 65, the "checkup" also includes the possibility of a one-time ultrasound examination, which is used for the early detection of dilatation of the abdominal aorta (so-called abdominal aortic aneurysm).

Screening for Men

A special preventive examination for men is prostate cancer screening as part of a genital examination, offered annually for men over 45 years of age. The examination includes a detailed review with the doctor about existing complaints or changes that have occurred, the so-called medical history. In addition, palpation examinations of the prostate and lymph nodes, as well as of the external genitalia, are carried out. Finally, there is a consultation where the results are reviewed and, if necessary, advice on how to proceed.

In addition, men over the age of 50 are entitled to colorectal cancer screening. Invitations and information letters are sent to men every five years from their 50th birthday on. Colorectal cancer screening in men provides for various measures. Early detection begins with a consultation with the physician, in which information about the possibilities of colorectal cancer screening is provided. The actual screening examinations represent a colonoscopy or a stool blood test, offered with varying frequency depending on age and risk factors.

Screening for Women

Special cancer screenings for women are for breast, cervical, and colorectal cancer prevention.

Colorectal cancer screening for women is similar to that for men. Here, however, the first colonoscopy is not offered before the age of 55.

For breast cancer prevention, an annual breast examination is offered from the age of 30, including a detailed medical history and palpation and inspection of the breast for abnormalities. In addition, the lymph nodes around the breast are palpated, and the patient is subsequently informed of the findings.

For women between 50 and 69 years of age, a further screening examination, the mammography, is offered every two years. This screening includes, among others, a written letter of invitation with a medical history form, the actual mammography, i.e., the X-ray of both breasts, and the reporting of these X-ray images by two physicians who raise the findings independently of each other. The result is delivered to the patient within seven working days.

For the screening of cervical cancer, women over the age of 20 are offered an annual genital examination, during which a vaginal exam is performed in addition to a conscientious medical history review. This examination includes an assessment of the cervix, gynecologic palpation, and a pap smear. The PAP smear is used to assess the cells of the cervix for typical cancerous changes. It is therefore also colloquially referred to as a "cancer smear." Women over the age of 35 also have the option of being tested for HPV (human papillomavirus) every 3 years in combination with a PAP smear. The annual PAP smear test is then not required.

In addition, preventive examinations for women also include all measures taken as part of prenatal care. This includes ultrasound examinations of the unborn child and the various examinations and tests that affect the health of the pregnant woman and later the woman who has recently given birth.

Furthermore, women up to the age of 25 are entitled to chlamydia screening once a year. Chlamydia infection is the most common sexually transmitted disease and can lead to infertility or complications in pregnancy if the infection persists. Screening is done using a urine sample.

Why are Screenings Important?

Screenings have a great value in medicine and great importance for the health of the individual. Many diseases that can have far-reaching consequences in later stages can be detected early and treated accordingly. Moreover, the rapid detection of the disease usually promises better treatment options and consequently a higher probability of cure.

In addition, health insurance companies often give a bonus to insured persons who regularly participate in preventive medical checkups. The preventive examinations can be documented with the help of so-called bonus books of the health insurance companies.

Sources

• www.bundesgesundheitsministerium.de/krebsfrueherkennung.html
• www.gkv-spitzenverband.de/service/versicherten_service/igel_leistungen/igel_leistungen.jsp
• www.bundesgesundheitsministerium.de/themen/krankenversicherung/online-ratgeber-krankenversicherung/medizinische-versorgung-und-leistungen-der-krankenversicherung/frueherkennung.html
• www.bundesgesundheitsministerium.de/service/begriffe-von-a-z/f/frueherkennung.html