One in eight cancer cases in Germany affects the intestine: around 33,000 men and 28,000 women develop colon cancer every year Robert Koch Institute. Overall, the numbers are decreasing thanks to prevention and early detection. However, experts report an increase in colon cancer among people under 50. In a to study has already been documented for Europe in the period from 1990 to 2016.
Being overweight and smoking are unfavorable
The number of diseases among young people aged 20 to 30 in Europe increased by an average of around 8% per year between 2006 and 2014. For those aged 30 to 40, it increased by around 5% per year. “The group of young sufferers poses a particular challenge in terms of detection, prevention and treatment,” says Professor Matthias Ebert, gastroenterologist and director of the 2nd Medical Clinic Mannheim.
The causes of this have not yet been conclusively clarified, but initial studies show: “Obesity, unhealthy diet, smoking and lack of exercise in particular have an unfavorable effect on the gut microbiome and fuel the development of cancer. Colon cancer was recognized early and has a good chance of being cured. Especially in the early stages, those affected often had no idea that they had the disease.
Persistent digestive problems, recurring diarrhea, and unwanted weight loss may be signs that you should see a doctor.
Professor Matthias Ebert, gastroenterologist at the 2nd Medical Clinic Mannheim
Tip: Keep risks under control yourself – with the right tools Diet and nutrition conceptsthe step to Do not smoke or aids like Smart watch or Blood pressure monitorthat measure parameters such as blood pressure and calorie consumption.
Stool test and colonoscopy show effect
Numbers of the German Cancer Research Center (DKFZ) show: National early detection programmes prevent many cases of colon cancer. It compared data from 3.1 million people affected by colorectal cancer from 21 countries. The numbers fell where people around 50 are invited to be tested for pre-cancerous lesions with stool tests and colonoscopy – as in the Czech Republic, Austria and Germany.
According to the Robert Koch Institute’s Cancer Registry Data Center, the number of new cases of colon cancer in this country fell significantly between 2010 and 2020: by about 13 percent among men and 17 percent among women. In countries without programs, however, the rate increased.
Tip: If you have a family history or unclear symptoms, you can have a colonoscopy earlier – for example at the age of 30 – at the cost of your health insurance. The prerequisite: The doctor must consider the examination necessary. You are entitled to a clarifying colonoscopy at any time.
People aged 50 and over are invited for early detection
Since 2019, people with statutory health insurance in Germany have been able to take advantage of an improved screening program so that colon cancer can be detected early. It includes several examinations at different time intervals. Between the ages of 50 and 65, those with statutory health insurance receive a letter from their health insurance company every five years inviting them to participate in free colon cancer screening offers. The letter contains detailed information about the investigations, data protection, rights to object and evaluations of the program. Previously, invitations of this type were only available to… Mammography. Experience shows that invitations increase the desire to participate.
Tip: Participation in colon cancer screening is possible even without an invitation – as long as the age is correct. Call your doctor. This shows what statutory health insurance companies offer in terms of additional early cancer detection examinations for women Health Insurance Comparison the Stiftung Warentest.
Colonoscopy is available for men over 50
The most important examination as part of the screening program is the colonoscopy – known in technical terms as a colonoscopy. Men can benefit from it with health insurance costs from the age of 50. The reason: they develop colon cancer more often and, above all, earlier than women. Regardless of age, according to the DKFZ, it affects 46 out of 100,000 men, but only 28 out of 100,000 women. There were even greater gender differences in precancerous lesions. For women, the official age for starting colonoscopy is 55.
Mirroring reduces the risk of death by 70 percent
Colonoscopy is considered a complex but reliable method. Specialists such as gastroenterologists use an endoscopic tube to examine the colon for tissue changes and can directly remove precancerous lesions such as polyps. Results of a long-term observation conducted by the University of Pennsylvania show that colonoscopy significantly reduces the risk of dying from colon cancer over the next ten years: Colonoscopy reduces the risk by almost 70 percent.
Those who arrive early are entitled to two reflections
Both sexes can have the test a second time at the expense of their health insurance – but only after a minimum interval of ten years, because colon cancer usually develops slowly. For example, those who want to be screened for the first time at the age of 65 or older are only entitled to a single early detection colonoscopy.
Stool testing remains a faster alternative
There is also a second legally funded early detection method – the stool immunological test (iFOBT). It replaced the previous chemical stool test in 2017. In the immunological test, a stool sample is tested for invisible traces of blood using antibody detection – possible evidence of a tumour. Men and women aged 50 to 54 are eligible for the test annually if they have not had a colonoscopy. People over 55 are eligible for it every two years – if they have not had a colonoscopy in that time.
Researchers at the German Cancer Research Center complain that only 10 percent of the men and 20 percent of the women contacted took the stool test. Apparently, participating is currently very complicated. The stool test must first be requested by the doctor, then carried out at home and brought back to the office. The researchers suggest sending the stool test to eligible people by mail in the future.
Important to know: General practitioners and some specialists, such as gynecologists, urologists or dermatologists, perform stool tests. If hemoglobin is detected in the stool, the suspicion of cancer can only be investigated with a colonoscopy.
Take advantage of a consultation
Insured persons may also obtain detailed advice from their physician on the preventive care program at the expense of the health insurance. All contracted physicians who perform early detection of colon cancer or health examinations are authorized to offer detailed and timely advice on the aim and purpose of the screening program.
Tip: The Federal Joint Committee provides new information sheets on the offer – for women It is for men.
Praise and criticism from cancer screening societies
The German professional associations of gastroenterologists consider the introduction of screening to be significant progress, but would have liked more regulations on some points. The German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS), early detection should begin in men from the age of 45. An earlier start of screening should also be established for relatives of patients with colon cancer, as they have an increased risk of cancer.
Possible family risk
Genetic defects or family history may increase the risk of colon cancer. Scientist at DKFZ assume that about one in four cases of colon cancer has a family history. The extent of the increased risk depends on several factors:
- First-degree relatives. If your parents, siblings, or children have colon cancer, your risk of colon cancer is about twice as high as that of people with no family history.
- Second degree relatives. If grandparents, uncles, aunts and grandchildren suffer from colon cancer, their own risk of colon cancer is also considered increased – but to a lesser extent than with first-degree relatives.
- Number of relatives affected. The more relatives who have been diagnosed with colon cancer, the higher the risk of developing it. It is considered four times higher if two or more first-degree relatives are diagnosed with colon cancer.
- Age of relatives at diagnosis. The younger the relatives were when they were diagnosed with colon cancer, the higher the risk of colon cancer. The risk is considered to be 1.8 times higher if relatives over the age of 60 had colon cancer. The risk increases up to 3.6 times if the relatives were under the age of 50 when they were diagnosed.
- Precancerous lesions in relatives. The risk of colon cancer is also increased if relatives have precancerous lesions (adenomas). According to the DKFZ, there are fewer studies on this aspect than on family history. It is assumed that the risk of adenomas in first-degree relatives also increases approximately twofold.