Preventive checkups in order to detect cancer
Unfortunately, our opportunities to prevent cancer are limited, although modern medicine offers us plenty of new options. Also a healthy lifestyle makes a huge contribution, especially a balanced diet is very important. Nevertheless, we cannot change our genes.
In the field of gynecology cancer prevention plays a big role. Especially the Pap smear test that was established all over Germany in 1971 helped to reduce the number of women suffering from cervical cancer.
All health insurance companies cover the annual gynaecological early detection of cancer for women from the age of 20 without an upper age limit. Since January 1, 2020, however, there has been an age-dependent gradation of the measures to be carried out with regard to cervical cancer screening.
Next to the general preventive checkups, new, extended checkups were invented. Among those are additional examinations that allow a higher reliability and new methods that will be carried out if you wish so. Those will not be paid by the statutory health insurance.
From the age of 20 years on ...
... the statutory health insurance covers the costs of examinations of the cervix and the Pap smear test. Also a gynecological palpation of the inner organs is included.
From the age of 30 years on ...
... additional palpation of the breast and lymph nodes in the armpits and neck are recommended.
From the age of 35 years ...
From the age of 35, a combined examination consisting of a Pap smear test and a HPV test is offered. The combined test is offered every three years.
From the age of 50 years on ...
... additional palpation and examination of the colon is included.
Of course, consultations concerning your bodily changes are included as well. If there are any suspicious indications of symptoms of diseases we will pay special attention to it.
The statutory health insurance covers all the costs of the above-mentioned examinations that are supposed to take place a minimum of once per year. I offer all those examinations in my medical practice.
Changes of the uterus and ovaries can be detected through palpation when they have reached a certain size.
Through a vaginal ultrasound a more detailed examination is possible. Even small changes can be detected. That is why we recommend this extra examination. It should take place once a year.
Cancer of the uterus can arise in the endometrium That disease seldom appears before the age of 50. Usually such changes occur after the menopause. The sonography can show changes, especially an endometrial hyperplasia. In some cases the polyp is benign. The examination with the ultrasound allows us to distinguish between benign and suspicious changes and depending on the result a small operation can solve the problem.
In the ovaries of fertile women smaller and larger cysts are frequently found. After the menopause those cysts should not appear anymore. The vaginal sonography allows us to distinguish between the various kinds of cysts. We are able to identify a malignant cyst.
Another entity we can find with the vaginal sonography is a uterine fibroid. Every third women at the age of 30 and older has fibroids; they can prevent pregnancy. I recommend a vaginal sonography before you plan to become pregnant.
This is a healthy uterus.
These pictures show normal ovaries.
Here we see a thickened endometrium.
For a more precise diagnosis the thin prep smear test was invented. That option is an addition to the Pap smear in order to detect cervical cancer.
The smear test will be put into a specific solution. Using a high-quality process the cells can be assessed in more detail. Especially misinterpretations based on impurity and inflammatory changes can be minimized.
In order to detect cervix cancer a further test, the HPV test, can be conducted. The virus HPV exists in many variations; some types belong to the "high-risk" group and are in most cases responsible for cervix cancer. In addition to that, smoking and recurrent inflammation increase the chances of developing cervical cancer.
30% of women above 30 years of age have an HPV-infection without having symptoms at first. In most cases the virus disappears on its own, if your immune system is strong enough. Nevertheless, the virus sometimes manages to integrate itself into the cervix cells, which then results in cancer.
For women over 35 years of age, the HPV test is covered by the statutory health insurance companies. The HPV test can also be used to clarify a conspicuous Pap smear.
A negative result on that test gives you a high assurance that you won’t have cervical cancer in the upcoming years. If the test results are conspicuous, the severity of the changes can be determined. You should, however, keep in mind that even a serious HPV-infection can disappear by itself.
An HPV-vaccination has been invented in recent years that women and girls should receive before they ever have intercourse.
In addition to the breast palpation I recommend an ultrasound examination for women above 35. Depending on the results that examination should take place every 6 to 24 months. It is a pain-free method without any side effects. Furthermore, it allows us to detect tumors that can not be found through palpation. As long as you are not in the menopause, the ultrasound examination has a couple of advantages compared to the mammography. You may find more information if you read here.
The costs of colonoscopy are paid for by the statutory health insurance for all patients over the age of 56. For people who do not wish to undergo a prophylactic colonoscopy, the health insurance companies offer a stool examination for occult blood every two years.
To optimize your checkups I recommend that you have examinations every year to check if there is blood in the stool. You should begin these tests when you turn 35, at the latest 45 years of age with the immunological test of the stool – simple and hygienic. Furthermore, you don’t have to change your diet prior to the test. The test checks whether hemoglobin can be found in your stool.