colon cancer screening

What is the colorectal cancer screening?

Colorectal cancer screening is part of the legal screening programs. Its purpose is to detect colon cancer (or precursors) as early as possible. Because the smaller the tumor is and the less it has spread, the better the chances of recovery. This is very important because colorectal cancer is very common: in Germany, it is the second most common among women and the third most common in men.

Depending on their age, the statutory and private health insurance companies pay certain examinations for general colorectal cancer screening. In addition, there is a closer-meshed early detection program for high-risk patients. These are people who are known to be at increased risk for colorectal cancer. This is the case, for example, when a first-degree relative (parents, siblings, children) already has colorectal cancer. Special recommendations on colorectal cancer screening also apply to certain hereditary diseases that promote the occurrence of colon cancer.

Possible tests for colorectal cancer screening include the test for tiny traces of blood (fecal occult blood) in the stool (hemoccult test) and colonoscopy (colonoscopy).

Experts also recommend a regular digital rectal examination from the age of 50 years. But it is not part of the statutory colon cancer screening!

General colorectal cancer screening

The General Colorectal Cancer Screening Program is for people who have no specific risk of colorectal cancer.

Digital rectal examination

With the digital-rectal examination (DRU), the doctor with one finger scans the inside of the rectum for changes. To do this, the patient lies on the left side of the body on the examination couch. An examination while standing with the upper body bent is also possible. The doctor then carefully guides one finger rectally – over the anus – (with gloves and lubricant). Carefully he scans the wall of the rectum. The examination takes only about a minute.

The digital-rectal examination is very important: colon cancer often arises in the rectum (rectal carcinoma). He can sometimes be touched directly during the examination. Therefore, physicians recommend that all people over the age of 50 years, undergo once a year digital-rectal examination. However, the health insurance companies do not cover the costs.

hemoccult

In the hemoccult test, a stool sample is examined for traces of blood that are not visible to the naked eye (occult blood). Since a colon cancer often bleeds, blood in the stool is an important symptom.

However, a positive hemoccult test does not mean that the patient is sure to have colorectal cancer. Because blood in the stool can also have other causes: For example, hemorrhoids or bleeding gums may be the reason if the hemoccult test is positive. Raw meats, certain vegetables and medications such as acetylsalicylic acid (ASA) or iron tablets can also falsify the test positively.

If the hemoccult test is positive, the exact cause must be clarified. Thus colon cancer can be clearly detected with a colonoscopy (colonoscopy).

Statutory claim: At the age of 50 to 54 years each insured person can undertake a hemoccult test once a year as part of the colorectal cancer screening at the expense of his health insurance.If you do not want to claim your right to colonoscopy (see below) from the age of 55, you can have a hemoccult test every two years instead.

Colonoscopy (colonoscopy)

The safest method of colorectal cancer screening is colonoscopy. The patient is under mild anesthesia a flexible tube (endoscope) introduced through the anus into the intestine. At the front end of the endoscope are a light source and a small camera. Carefully, the doctor pushes the endoscope through the entire colon. In this way, he can constantly inspect the images taken by the camera from the inside of the intestine on a monitor.

If required, fine instruments can also be inserted via the endoscope. With their help, the doctor can take tissue samples and excise intestinal polyps for accurate laboratory analysis. In almost all cases, initially harmless colon polyps form the starting point of colon cancer. Precaution therefore exists in the removal of suspicious polyps.

The colonoscopy is in principle very low risk. Sometimes, however, the endoscope will hurt the intestinal wall. However, serious complications are rare in this study. The great benefit of colonoscopy in colorectal cancer screening outweighs any risks significantly.

Statutory claim: From the age of 55, health insurance holders are entitled to at least two colonoscopy. If the first colonoscopy remains inconspicuous, the second colonoscopy is paid for by the health insurance companies at the earliest after ten years (colon cancer, in fact, develops only slowly). If you do not want to have colonoscopy done, you have the alternative to a hemoccult test every two years.

Colorectal cancer screening in high-risk patients

If you have first-degree relatives (parents, siblings, children) who already have colorectal cancer, you are considered a high-risk patient. Then you should have the colonoscopy performed at an age that is ten years before the age of your relative’s illness (and at the age of 50 at the latest). For example, if your father has been diagnosed with colon cancer at the age of 55, you will be recommended to colonoscopy at the age of 45. If your father was already 75 at diagnosis, you should go to colonoscopy by the age of 50 at the latest.

Individuals with certain hereditary diseases that increase the risk of colorectal cancer are recommended to have an individual colorectal cancer screening. The attending physician orients himself thereby on the guidelines for the diagnostics of the genetic disposition for cancers of the German Medical Association in Germany. Even with the chronic inflammatory bowel disease ulcerative colitis, an individualized colorectal cancer screening plan is advisable.

The reimbursement by the statutory health insurance should best clarify before the investigation.

Colorectal cancer screening: What can I do myself?

Effective colorectal cancer screening is not just about participating in the recommended screening tests. Anyone with a healthy lifestyle can also help prevent colon cancer:

• Avoid nicotine and alcohol. Both stimulants increase the risk of colon cancer and other cancers.
• Eat low in meat and fiber with plenty of fruits and vegetables. A meat-and-fat diet low in fiber promotes the development of colon cancer.
• Physical inactivity is another risk factor for colorectal cancer. So be physically active regularly!

The bad influence of unhealthy diet and physical inactivity is due to the fact that they slow down the transport of food residues through the intestine. Any pollutants and toxins in the stool then remain in contact with the intestinal mucosa for a longer period of time and can more easily damage them.

Obesity and type 2 diabetes (type 2 diabetes) also promote the development of colon cancer due to increased insulin levels (insulin generally stimulates cell growth). Obese people and diabetics should be colon cancer screening Therefore, take it very seriously.