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Digestive Disorders > Lower Abdomen

Colon cancer screening – What is done and when it makes sense to do it early

Dr. med. André Sommer

Dr. med. André Sommer

Preventive medical checkups are an important pillar of our health care system. With their help, diseases without symptoms in particular can be recognized at an early stage. The examination for colorectal cancer screening has great success. Because timely diagnosis increases the chance of recovery. Colon cancer often arises from benign polyps. These are discovered during the preventive examination using a colonoscopy and removed as a precaution. This reduces the risk of developing colon cancer.

What types of colorectal cancer screening are there?

There are two ways to diagnose colon cancer:

  1. iFOBT: Immunological stool examination for occult blood (formerly: Hemoccult)
  2. Colonoscopy (colonoscopy)

Both test procedures are an integral part of the preventive medical checkups. They are covered by the statutory health insurance. The immunological stool examination is relatively new. As the analysis takes place in the laboratory, the result is only available after a few days. However, the test procedure is much more accurate than the hemoccult test performed previously.

The colonoscopy is even more precise by looking closely at the intestinal mucosa. Here, benign protuberances of the intestinal mucosa, so-called polyps, are discovered and then removed. Some intestinal tumors do not bleed permanently and can therefore not be noticed in the stool test. However, they do not go undetected in a colonoscopy.

When is colon cancer screening started?

Since 2018 there have been new guidelines for colorectal cancer screening. Colon cancer screening generally begins at the age of 50. Now the stool examination can be carried out annually for invisible (occult) blood (up to 54 years). If this test is remarkable, a colonoscopy is always recommended. This is the only way to find out the cause. But not every positive result in a stool test means colon cancer.

Men aged 50 and over are entitled to preventive colonoscopy. In women, colonoscopy is only taken over by health insurance companies from the age of 55 if there are no symptoms. For colon cancer screening, a colonoscopy is the recommended method. However, if you do not want a colonoscopy, you can continue to do the iFOBT every two years.

When is colon cancer screening appropriate in the family?

Is colon cancer or polyps common in your family or has a first degree relative suffered from colon cancer? Then the risk of developing colon cancer is increased. In this case, the preventive medical checkup is particularly important. Because intestinal tumors are often found at a young age, precautionary measures also begin earlier.

It is recommended to take the first preventive care ten years before the age at which the family member became ill. If your father suffered from colorectal cancer at the age of 40, you should do the first screening at 30. Your family doctor or gastroenterologist will advise you on this.

Info: Men have a higher risk of developing colorectal cancer than women. This has been shown by new studies. That is why men are now entitled to screening colonoscopy from the age of 50

Colon cancer screening for women at a glance:

Between the ages of 50 and 54:
  • Consultation
  • Annual iFOBT stool test for invisible blood
From the age of 55
  • Consultation
  • Screening colonoscopy \ or
  • iFOBT every two years if no colonoscopy is performed
Ten years later
  • Second screening colonoscopy at the earliest 10 years after 1st colonoscopy

Colon cancer screening for men at a glance:

Between the ages of 50 and 54:
  • Consultation
  • Annual iFOBT stool test for invisible blood
From the age of 50
  • Consultation
  • Screening colonoscopy (recommended) \ or
  • iFOBT every two years if no colonoscopy is performed
Ten years later
  • Second screening colonoscopy at the earliest 10 years after 1st colonoscopy
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What is the goal of colorectal cancer screening?

Colon cancer screening saves lives. - Because early detection and treatment improve the prognosis of colorectal cancer. Colon cancer is one of the most common cancers in Germany. Since it has a long course without symptoms, it is often discovered too late. Every year, 20,000 people die from the insidious disease.

Info: The joint federal committee has decided that insured persons will be invited in writing by the health insurance companies for a medical checkup starting October 2018. It hopes that in the future more people will take part in the preventive medical checkup and benefit from it in terms of health.

How often is colon cancer screening done?

It depends on the screening method. The general rule:

  • Men (over 50) and women (over 55) are entitled to two colonoscopies as part of early detection. The two examinations must be at least ten years apart.
  • Between 50 and 54, the iFOBT stool examination can be performed annually. Then it is possible every two years if a decision is made against colonoscopy

What does colorectal cancer screening cost?

Due to the legal regulation, you have the right to the described preventive examinations from 50 or 55 years of age. The costs are therefore borne by the statutory health insurance companies. Many private health insurance companies also cover the cost of preventive medical checkups.

Are you younger than 50 and would you like to receive colon cancer screening? Doctors can also offer the tests earlier. Unfortunately you have to pay for this service yourself then. In some cases, however, reimbursement by the health insurance company is possible. It is best to discuss this with your doctor and your health insurance company.

What kind of doctor performs colorectal cancer screening?

The first point of contact is often the family doctor. But gynecologists and urologists also provide information about the colon cancer screening examinations. In addition to counseling, general practitioners, gynecologists and urologists can carry out the iFOBT immunological stool sample. The stool sample is sent to a laboratory and analyzed there. You will be informed of the result a few days later.

A colonoscopy can only be performed by a gastroenterologist. The examination is more complex, but the result is more certain.

Don't worry A colonoscopy is a very safe procedure. Complications only occur in very rare cases. These are usually easy to treat. Discuss your concerns with your doctor. Many people don't dare to go to the doctor out of fear or concern about the result of the examination. In most cases, this fear is completely unfounded and the test result is negative. If an abnormality is discovered, colon cancer can be cured. To do this, therapy must be started early. But an ounce of prevention is always worth a pound of cure here.

What kind of precautions can I take?

People with a healthy lifestyle are less likely to develop colon cancer. If you pay attention to a healthy diet, exercise enough and do not smoke, you will strengthen your health. Would you like to learn more about a suitable diet for good intestinal health? Get advice from one of our certified nutritionists and work with her or him to create an individual nutrition plan. Find out more in a free initial consultation.

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Mitteilung DGSV (2018). Neuregelung zur Darmkrebsvorsorge. Z Gastroenterol, 56, 1173-1184. Downloaded on 09/11/2018 from:

Ziegler, M., Krause, S., & Kolligs, F. T. (2011). Ärztliche Aufklärung über Darmkrebs und Darmkrebsvorsorge. Zeitschrift für Gastroenterologie, 49(05), 584-590.

Dr. med. André Sommer

Dr. med. André Sommer

I’m André, a medical doctor from Berlin. Together with a team of medical doctors, nutritionists and data scientists we empower people to understand digestive issues with our app Cara Care.

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