More exercise and sports, more relaxation or a healthier diet. Particularly at the beginning of each new year, many people have these good intentions and want to do more for themselves and their health. However, check-ups and preventive examinations should also not be ignored.
Because: Medical preventative exams help reduce our risk for developing diseases or help recognise diseases in an early stage, thereby increasing the likelihood of curing them. The statutory health insurance pays for many, but not for all, check-ups. The following overview serves to point out important screening options.

The Federal Committee of Physicians and Health Insurances set guidelines for early detection and specific examination steps that are performed from the first minutes after you are born to when you become an adult. U1 to U9 follow the child up to one year before enrolling in school. Während der Schulzeit werden weitere Untersuchungen angeboten. A last examination in adolescence can be performed between 17-18 years of age. The focal points of this series are not only the recognition of developmental disorders but increasingly also a consultation about healthy behaviour.

Preventative examination starting at age 18

Women and men aged between 18 and 35 years are entitled to a one-off check-up, i.e. a detailed examination, to determine their health status. The examination supports the early detection of e.g. cardiovascular diseases and diabetes.

From the age of 20, preventative skin cancer examinations can be undertaken every one to two years to detect any development of malignant skin tumours. The statutory preventative examination is, however, only provided starting at age 35.

Preventative examination for women starting at age 20

The gynaecologist performs a gynaecological examination once a year in women starting at age 20 to minimise the risk of cervical cancer and cancers of the genital tract, e.g. ovarian cancer. In women, cervical cancer is one of the most frequently occurring cancers. During the preventive examination, the gynaecologist takes a pap smear from the cervix in order to screen it for cancer-causing viruses, so-called human papilloma viruses (HPV). The risk of infection increases with the number of sexual partners, as the virus can be transmitted through unprotected sexual intercourse. The costs of the preventive gynaecological examination are covered by the health insurance companies, with the exception of additionally offered examination services (e.g. ultrasound).

New: From 1 January 2020, women aged 35 and over will be entitled to a combined screening consisting of a cytological examination and an HPV test every three years.

For women over the age of 30 years, breast cancer prevention is also offered with examination of the breast and lymph nodes. This can also be done on your own with a monthly self-check exam. The treating gynaecologist supports patients in this process by showing them how to examine themselves. During self-examination, every part of the breast should be systematically palpated to detect any changes at an early stage. Applying light or stronger pressure, women should palpate the breast tissue directly under the skin as well as in depth with their fingers. The edge of the pectoral muscle in the direction of the armpit and the armpit itself should also be palpated. This is best performed with a lowered arm.

Preventative examination starting at age 35

A thorough check-up every three years starting at age 35 helps detect any diseases in the earliest possible stage, for example cardiovascular diseases (such as high blood pressure) or diabetes. A full physical exam and laboratory tests are given. The latter help detect normal and abnormal organ function. Ultrasound tests can be performed in addition, for example on the abdomen (lower body), thyroid and lymph nodes in the neck. These ultrasound imaging tests show the shape of organs that deviate from a healthy shape. Ask in advance which preventative examinations your health insurance covers.

In addition, skin cancer screening is recommended for women and men every two years from the age of 35. This involves examining the entire skin for suspicious changes. Some health insurance companies cover this service at an earlier stage. It is best to find out in advance whether your health insurance company is included.

Preventative examination starting at age 45

Men over the age of 45 years are entitled to an annual cancer screening examination of the genitals and prostate, as the risk of e.g. prostate cancer increases significantly with age. This screening includes an examination of the external sexual organs, the prostate, the anus and the lymph nodes.

In men and women aged 50 years and over, the general physician should carry out examinations for colon and colorectal cancer. Colon cancer is one of the most frequent cancers in Germany. The risk of colon cancer increases with age, but colon cancer is rare in people under the age of 50 years. For men and women, this screening includes advice on the colorectal cancer screening programme and an annual test for non-visible (occult) blood in the stool between the age of 50 and 54 years. In addition, men over the age of 50 years can optionally have two colonoscopies performed at a minimum interval of ten years as a precautionary measure.

Women over the age of 50 years and under the age of 70 should have a mammography performed at special practices every two years for breast cancer prevention. The women are invited to the examination by mail.

Preventative examination starting at age 55

From the age of 55 years, men and women are entitled to a choice of two examinations as part of colon/colorectal cancer screening. On the one hand, they can have a test performed for invisible (occult) blood in the stool every two years.  On the other hand, there is the option of two colonoscopies at a minimum interval of ten years.  

Preventative examination starting at age 65

Since 2018, men over the age of 65 have been entitled to a once-off preventive examination for the early detection of abdominal aortic aneurysms. The aorta is the largest artery in the body and distributes blood enriched with oxygen throughout the organism. The abdominal aorta is the part of the main artery that runs through the abdominal cavity. In the preventive examination, the abdominal artery is examined using ultrasound to see whether it has formed a bulge (aneurysm). So lässt sich erkennen, ob sie eine Ausbuchtung (Aneurysma) aufweist. Although this is rather rare, men over the age of 65 are at increased risk. If the abdominal aorta has a bulge or is severely dilated, it may rupture at this point. A ruptured aortic aneurysm can be fatal.