Many men shy away from medical check-ups and thus miss the opportunity to detect diseases in the early stages. A doctor explains which checks are important.
The most important things at a glance
Preventive medical check-ups help to identify certain health risks and illnesses at an early stage. In Germany, people with statutory health insurance are entitled to various free check-ups. Doctors also offer paid examinations.
But which precautions are particularly important for men and where is the data uncertain?
What counts as a preventive check-up?
Medical check-ups are examinations that help to detect diseases such as cardiovascular diseases and cancer at an early stage. Doctors therefore speak of early detection measures. Colon cancer screening, for example, offers “real” screening. Since the doctor can remove precancerous lesions during the colonoscopy, colon cancer can actually be prevented.
The early detection of diseases and cancer can be roughly divided into two groups for those with statutory health insurance: early detection measures, the costs of which are covered by health insurance companies, and what are known as individual health services (IGeL), the costs of which the patient has to bear themselves.
What screening tests are there for men?
Various screening tests are available for men. The following are covered by the statutory health insurance companies:
- Check-up: Early detection of cardiovascular diseases and diabetes, among other things. The examination is taken over once between the ages of 18 and 34 years. It includes the collection of the medical history of the patient (anamnesis), a physical examination, blood pressure measurement, checking the vaccination status and a consultation on the examination results. Optionally, measurements of blood fat and blood sugar levels supplement the examination.
- Annual dental check-up: Once a year, men can have their teeth and gums examined for tooth decay or periodontal disease. Tartar is also removed.
- Annual ophthalmological check-up: Examination of the eyes and recording of the visual values.
- Check-up 35: From the age of 35 men are entitled to a check-up every three years. In addition to the physical examination, checking the blood values and a urine test, the vaccination status is also checked.
- Skin cancer screening: Also from the age of 35, men can take advantage of an early detection examination for skin cancer every two years. The dermatologist examines the skin for changes that indicate white or black skin cancer.
- Early detection of prostate cancer and cancer of the external genitals: From the age of 45 men can attend the early detection of cancer of the prostate and genital area once a year. Not only the external sex organs and the local lymph nodes are scanned, but also the prostate via the rectum.
- Colon cancer check-up: Men over the age of 50 can use colorectal cancer screening. You have the choice between a colonoscopy and a stool test for hidden (occult) blood. Men between the ages of 50 and 54 can take the stool test once a year. Men can have a colonoscopy twice at intervals of ten years – provided the first examination is unremarkable. Otherwise, the examination period will be shortened. From the age of 55 men can have a stool test every two years or opt for a colonoscopy.
- Early detection of abdominal aortic aneurysm: From the age of 65 men can have a one-time early detection of an abdominal aortic aneurysm. The abdominal aorta is examined using ultrasound. Men are significantly more likely to be affected by an abdominal aortic aneurysm than women. According to scientific studies, about two percent of all men between the ages of 65 and 75 have an aneurysm of the abdominal artery. For women, this examination is not included in the catalog of services provided by statutory health insurance companies.
Furthermore, men have a number of different IGeL available, which are usually not covered by health insurance, including for example:
- Professional tooth cleaning
- Glaucoma Early Detection
- Examination of the skin with a magnifying glass
- PSA-Test
- Ultrasound examination of the prostate
- Ultrasound of the urinary tract to detect bladder cancer
- Urine test for early detection of bladder cancer
Which screening tests for men are particularly important?
“The three statutory cancer screening tests for men are colon cancer screening, skin cancer screening and prostate cancer screening,” says Dr. Susanne Weg-Remers, Head of the Cancer Information Service (KID) at the German Cancer Research Center (DKFZ) in Heidelberg. “Every man should inform himself in detail about the early detection examinations and look individually at what he is hoping for and what risks are possibly associated with the examination.”
Colorectal cancer screening: colonoscopy or stool test better?
For early detection of colon cancer, the cancer expert recommends men to use the colonoscopy as a preventive tool. “Colonoscopy can be used to precisely identify pre-cancerous stages, so-called polyps – and remove them immediately. The stool test for hidden blood, on the other hand, only detects a colon tumor if it gives off blood. With the stool test, the risk of colon cancer being overlooked is higher.”
Prostate cancer screening: is the palpation sufficient?
When it comes to early detection of prostate cancer, it is often difficult for men to make a decision. The tactile examination, which is covered by the statutory health insurance companies, is matched by the individual health service “PSA test”. Both screening tests are hotly debated and have both advantages and disadvantages. The earlier and more detailed information men get, the easier it is for them to make a decision.
“It has to be said that palpation can only detect tumors that grow on the side of the prostate facing the intestines and are larger than one centimeter,” explains Weg-Remers. “Early tumors cannot be detected by palpation.” The PSA test, on the other hand, has the advantage that it can detect prostate cancer at an early stage. If, for example, prostate carcinoma has occurred in the family, for example in the father, uncle or comparable family members, it can be advisable to take the PSA test in addition to the palpation.
Risk of false positive result in the PSA test
With the PSA test, which determines the value of the prostate-specific antigen by examining a blood sample, there is an increased probability of false-positive results. Then it can happen that men undergo a biopsy because of elevated PSA levels, even though there is no cancer.
“In addition, prostate cancer is often not very aggressive. However, many men do not want to live with the diagnosis of prostate cancer. In many cases, treatment can be delayed and treatment can be delayed if the tumor does not grow aggressively. But most men opt for the procedure . You want to get the cancer out of your body,” says Weg-Remers. It can happen that a tumor is operated on or given radiation that might never have caused serious problems. And the men have to live with the risks and side effects of prostate surgery or radiation therapy, such as temporary or permanent incontinence or impotence.
