[Examples of screening investigations]

Primary prevention of cancer still only finds limited acceptance in the general population, therefore, secondary prevention plays an important role in order to avoid the high costs necessary for the treatment of advanced forms of cancer. Breast cancer, prostate cancer and colorectal carcinoma (CRC) are the most common forms of cancer with high mortality and a high socio-economic impact. Screening tests for these diseases are effective and simple to carry out. The measures for secondary prevention are well known but are only implemented to approximately 30-40%. For persons over 55 years old routine screening at 10-year intervals by ileocoloscopy is now established for CRC, or alternatively an annual examination for occult blood in faeces (FOBT) over 50 years of age. Screening mammography for women aged between 50 and 69 years old is firmly established in the guidelines of the Gemeinsamer Bundesausschuss since 2004 for early recognition of cancer. It is anticipated that the establishment of the screening programme in Germany will be completed in all Federal States by the end of March 2008. All men over 45 years of age who are compulsory insured are entitled to have an annual examination of the external genital organs and a digital rectal examination of the prostate under the compulsory cancer early recognition programme. PSA testing within the framework of preventive examinations is, however, not yet part of the catalogue of available tests.