Stools cause cancer

Colon cancer screening: stool sample or mirror?

Status: 01/30/2020 2:38 p.m. | archive
Medical checkups save lives - too many are wasting the chance.

Colon cancer is curable in more than 90 percent of cases if it is detected early. After the introduction of the preventive medical check-up, the number of new cases every year aged 55 and over fell by around 20 percent. Since 2002, 130,000 deaths and 270,000 new cases have been prevented. Nevertheless, so far only one in four has taken up colorectal cancer screening.

Why early detection is so important

Most tumors in elderly patients are still discovered purely by chance. Colon cancer causes no pain and hardly any symptoms for a long time. This is why the disease is often diagnosed late and the death rate is then very high. Constipation, intestinal cramps, and blood or mucus in the stool only appear at an advanced stage. Many of those affected only come to the clinic with these symptoms. In order to improve the early detection rate, the health insurance companies send out the invitation letters every five years.

Colonoscopy complications are very rare

Many people fear a colonoscopy. Many also find the preparatory colon cleansing, for which you have to drink at least two liters of rinsing liquid, unpleasant. A colonoscopy is not dangerous, complications are very rare. The chances of successful cancer screening far outweigh the risks. Studies show that after an inconspicuous mirroring, the next colonoscopy usually does not have to be performed for ten years.

Prevention with a stool test

At least a first step in prevention are stool tests that look for hidden blood. In the meantime, numerous studies have shown that the relatively new immunological tests can detect colon cancer and its precursors even more frequently than the so-called guaiac test, which was used in the past. Immunological fecal occult blood tests (iFOBT) can detect invisible blood in stool with greater accuracy and certainty. Since 2017, the statutory health insurances have been covering the costs of the immunological test for people aged 50 and over - the prescription is issued by the family doctor or a doctor who carries out cancer screening examinations. Anyone who has cases of colon cancer in their families should seek advice and start early detection examinations much earlier.

Advantages of the immunological test

Immunological tests use special antibodies to look for blood components, the protein molecule haptoglobin. In contrast, guaiac tests show the red blood pigment hemoglobin. Advantage of the immunological tests: They can detect tiny traces of blood even if the red blood cells have already been broken down during the intestinal passage. They only need to be repeated every two years and only require a one-time stool sample.

Stool sample is examined in the laboratory

In the immunological test, a fall arrest aid is placed in the toilet before a bowel movement. The tip of the test stick is used to stroke the stool sample at various points. The grooves in the tip must then be completely filled with stool. The test stick is given in the sample tube to the doctor, who sends the sample to a special laboratory. In contrast to the guaiac test, there is no indicator liquid that is dripped onto the sample and stains hidden blood. The new tests require special equipment for evaluation.

Safety through colonoscopy

If the test finds a large amount of haptoglobin in the stool, the risk is increased that a bleeding polyp or colon cancer in the upper part of the intestine is the cause. In this case, a more detailed examination by colonoscopy will follow. Despite the advances in laboratory diagnostics, colonoscopy remains the gold standard in the early detection of colorectal cancer from the age of 55. It must be done if the immunological test is successful to find out the cause of the bleeding. A colonoscopy can also help doctors identify other diseases and remove precursors or early forms of colon cancer.

Provision: what the health insurers take over

  • In old age from 50 to 54 Years can women and men Have an immunological test (iFOBT) carried out annually for occult (invisible) blood traces in the stool.
  • From the age of 50 Years have Men Entitlement to two early detection colonoscopies (colonoscopies) at least ten years apart. If the offer is only taken up from the age of 65, one is entitled to an early detection colonoscopy.
  • From the age of 55 Years have Women Right to two screening colonoscopies at least ten years apart. If the offer is only taken up from the age of 65, there is the right to an early detection colonoscopy.
  • From the age of 55 Years women and men Entitlement to an immunological test (iFOBT) every two years, as long as no screening colonoscopy has been taken.
  • In the case of abnormal stool tests, you are entitled to a diagnostic colonoscopy.
(Source: Federal Joint Committee - G-BA, as of April 2019)

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