For many cancers, preventive and early diagnosis examinations play an important role, including colon cancer.
Since cancer cells in colon cancer often develop from benign precursor cells, preventive examinations from a certain age are very important. During these preventive examinations, such Cancer precursors are discovered and removed before transformation into malignant cancer cells occurs.
There are various preventive and early detection measures for colon cancer that are recommended from a certain age and are financially covered by health insurance companies.
Colonoscopy (colonoscopy)
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Digital rectal examination (the attending physician palpates the lower rectum with your finger)
Test for hidden (occult) blood in the stool
M2-PK stool test
Genetic test (to rule out HNPCC (hereditary non-polyposis colorectal cancer or Lynch's syndrome) and familial adenomatous polyposis (FAP))
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In colon cancer, tumor cells grow in the area of the colon or rectal lining. These can cause small bleeding by growing into small blood vessels or from their own blood vessels. The blood enters the intestines and is eliminated with the stool. Usually this bleeding is so small that the blood in the stool cannot be seen with the naked eye. There are therefore tests that can detect this invisible, i.e. hidden or occult, blood in the stool.
Until the beginning of 2017, the guaiac test, often referred to as the haemoccult test after the product name, was the standard method for detecting occult blood in stool. In this test, a small sample of stool is placed on a card, the doctor then drips a special solution onto the card, and if there is blood in the stool, the card changes color. This is a chemical stool test because the blood in the stool is detected by a chemical reaction.
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Read more on the subject at: Blood in the stool
An immunological test procedure has replaced this chemical test since 2017. It's called the iFOBT test. Here, too, the patient gives a small stool sample and this is filled into a tube provided by the patient, which he receives from the family doctor. The tube is then returned to the family doctor who sends it to a specialized laboratory. Antibodies that specifically bind to the red blood pigment (hemoglobin) are used to detect hidden blood in the stool with iFOBT.
The immunological test has the advantage, among other things, that no false results arise from the fact that the patient consumed certain foods shortly before the stool sample was given. In addition, the iFOBT test probably has a higher sensitivity (test detects sick people) and specificity (test does not incorrectly recognize healthy people as sick) than the Haemoccult test. From the age of 50 onwards, the iFOBT is carried out every 2 years by the health insurance companies.
Colonoscopy is the gold standard for colorectal cancer diagnostics. It is also the only examination that can be understood as a preventive examination. With a colonoscopy, cancer precursors can be detected. With the test for hidden blood, on the other hand, no preliminary stages are detected, but the test provides information that a cancer is already present. So while the colonoscopy is a preventive check-up, the test for occult blood is strictly an early diagnosis.
From the age of 55, the colonoscopy is financially covered by health insurances twice at an interval of 10 years. If the preventive colonoscopy reveals an abnormal finding and if, for example, precancerous stages, so-called polyps, are recognized and removed, the control interval is reduced.
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More information on this topic: The course of a colonoscopy
The previously mentioned immunological test for hidden blood (iFOBT) is taken home by the patient. There the patient fills the stool tube and then takes it back to the family doctor, who then sends it to a specialized laboratory. However, there is also an immunological test that can be done entirely at home by the patient. It is called the FOB self-test. The test is not paid for by the statutory health insurance and costs just under 20 euros. Just like the iFOBT, it uses an immunological method to detect red blood pigment in stool.
Another colon cancer test that is done partially at home is the M2-PK stool test. This test detects a specific colon cancer enzyme in the stool. You can either purchase the test yourself and send it to a specialized laboratory or have it handled by your family doctor. This test is currently not recommended in the colorectal cancer guidelines and is therefore not covered by health insurance companies. The cost is around 30 to 40 euros.
Also read our topic: What is the Typical Age for Colon Cancer?
It is important to know that an online self-test can never replace a visit to the doctor.
Very often, however, one can already get an initial picture of the situation based on such a test and accordingly assess the urgency of a medical clarification. You should also use such offers to familiarize yourself with the most important questions (which the doctor will also ask you) and thus facilitate the conversation with the doctor.
Go to our colon cancer self-test here: Colon cancer self-test
