Cancer, heart attack, stroke: These preventative checks save lives

Every year in Germany, around one million people die – more than half of them from either cardiovascular disease or cancer. Yet, for some of these dangerous diseases, effective prevention options exist. For example, colorectal or breast cancer has a good chance of being cured if detected early. The risk of heart attacks or strokes can be assessed by certain blood values ​​and reduced with early intervention. In short: prevention can save lives.

However, some important preventative health checkups are underutilized, with significant differences between the German states. Where are these crucial checkups not taken seriously enough? And which examinations are you entitled to?

Three values ​​are particularly important here: blood pressure, blood lipid levels, and blood sugar. These are checked as part of a general health check-up . This examination is available to everyone aged 35 and over. Younger people from the age of 18 can also have the check-up once, but blood tests are only performed if there are existing risk factors.

High blood pressure can damage blood vessel walls in the long term. Blood lipids such as cholesterol and triglycerides can accumulate in the arteries and clog them. If a blood clot forms from these deposits, it can block the blood supply to the heart or brain, leading to heart attacks or strokes. Early detection of high blood sugar levels, on the other hand, can help prevent diabetes. In some cases, blood sugar levels can still be lowered through exercise and diet before permanent damage occurs.

A large majority of adults in Germany apparently take blood pressure checks seriously – particularly in Thuringia, Saxony, and Brandenburg, according to data from the Robert Koch Institute (RKI). The situation is less favorable for blood lipids and blood sugar. Nowhere do more than two-thirds of adults have these checks done.

There are two options for colorectal cancer screening. Women and men aged 50 and over can have a test for hidden blood in their stool – annually from age 50 and every two years from age 55, if they are not having a colonoscopy. Alternatively, men aged 50 and over and women aged 55 and over are entitled to two colonoscopies ten years apart.

Colonoscopy offers a clear advantage. Blood in the stool is only found in cases of already established tumors, and even then, not always. However, during a colonoscopy, the doctor can directly examine the colon and detect even the smallest changes. Polyps, from which most colon tumors develop, may also be visible. These polyps can be easily removed during the procedure, preventing the development of a malignant tumor in the first place. This is cancer prevention, a step beyond early detection.

This is likely why more people opt for a colonoscopy than for a stool test for blood. However, at only 60 percent of those eligible for preventative care, this is still insufficient. The rates are particularly low in Thuringia and Saxony-Anhalt.

Women as young as 30 can undergo breast cancer screening via palpation . Women between 50 and 75 are entitled to a mammogram every two years – an X-ray examination of the breast that can detect even small tumors. Women who participate in multiple screenings benefit particularly.

As part of the German mammography screening program, around 5.6 million women between the ages of 50 and 69 received an invitation to participate in the examination in 2022. This represented more than 90 percent of all women of screening age. The screening program proved worthwhile: Over 80 percent of the detected carcinomas were in a stage with a favorable prognosis.

However, only about half of those invited attended. In Berlin, Baden-Württemberg, and Bavaria, the turnout was even below 50 percent.

In addition to the above-mentioned preventive checks, statutory health insurance companies also cover further examinations:

From the age of 35, a skin cancer screening is possible every two years. This is generally also possible at general practitioners' offices, provided they have the necessary qualifications and have received approval from the Association of Statutory Health Insurance Physicians.

For women, there are two screening tests for cervical cancer. From the age of 20, women are entitled to an annual Pap test. This involves taking a cell sample from the cervix and examining it in a laboratory. From the age of 35, women can combine the Pap test with an HPV test every three years. The latter checks for human papillomavirus (HPV). Certain viruses from this group are considered the main cause of cervical cancer.

Men aged 45 and over are entitled to an annual prostate cancer screening. While statutory health insurance covers the digital rectal exam, experts no longer recommend it: not only is the examination unpleasant, but it also cannot reliably detect prostate cancer. Studies show that it only detects one in three carcinomas – and usually only larger, advanced tumors can be felt. Instead, urologists recommend an individually tailored PSA test. This test measures the amount of prostate-specific antigen (PSA) in the blood. Elevated levels can indicate cancer. The PSA test is not currently covered by statutory health insurance.

Finally, since 2019, men aged 65 and over have been entitled to a one-time ultrasound examination for abdominal aortic aneurysms . These enlargements of the blood vessels are relatively common in older men, and in rare cases, they can rupture. To prevent this life-threatening emergency, larger aneurysms can be surgically repaired as a preventative measure. For smaller vascular enlargements, observation is sufficient.