Picture above: Dr Ursula Strate (centre) is one of the endoscopy specialists at the MEDIZINICUM Hamburg at Stephansplatz and, in addition to bowel cancer screening, deals primarily with autoimmune diseases of the digestive system such as autoimmune hepatitis, autoimmune pancreatitis, ulcerative colitis or Crohn's disease.
According to calculations by the World Health Organization (WHO), colon cancer, with a share of around ten percent, is the third most common cancer after lung and breast cancer. After lung cancer, colorectal cancer is even the second deadliest cancer disease, accounting for 9.2 percent of cancer-related deaths. Colorectal cancer is particularly prevalent in industrialized countries, despite the fact that it is precisely here that screening programs are available that could dramatically reduce the risk of colorectal cancer if they were used consistently. To remind people about colorectal cancer screening, the Felix Burda Foundation has proclaimed March Colorectal Cancer Awareness Month every year since 2002. In this way, the dedicated foundation seeks to promote the use of screening and in this way save many lives.
Bowel cancer screening in Germany
From the age of 50 onwards, a so-called occult blood test should be performed annually. A stool sample is examined for the smallest traces of blood that are not visible to the eye. If this test is positive, it indicates an increased probability that colorectal cancer may be present. A colonoscopy is then performed for a reliable diagnosis. Studies show that on average one death from colorectal cancer can be prevented per 1,000 occult blood tests performed.
In people who do not show any symptoms, a screening colonoscopy is offered in addition to the occult blood test at the age of 50 (men) or 55 (women), and another one 5-10 years later. If polyps are found during the examination that could develop into colorectal cancer in the long term, they can be removed painlessly as a precaution. Therefore, the Colorectal cancer screening is not just a screening examination as is the case with other types of cancer, but a genuine preventive measure that can prevent cancer from developing. The fact that colorectal cancer screening is only offered as a general health insurance benefit from the age of 50 is only due to the fact that more than 90 percent of all colorectal cancers occur from this age. However, this does not mean that colorectal cancer cannot also develop at a younger age.
An increased risk of colorectal cancer is associated with a family history of obesity, chronic inflammatory bowel disease and lifestyle factors such as high meat consumption, smoking, alcohol and lack of exercise. If a first-degree family member (parents, siblings, grandparents) developed colon cancer, the first colonoscopy is recommended much earlier - ten years before the age at which the cancer was discovered in the family member.
Preventive colonoscopy at the MEDIZINICUM Hamburg
At the MEDIZINICUM Hamburg, preventive colonoscopies and other colonoscopies are performed for all patients (private and health insurance patients, self-pay patients) by the endoscopy specialists Dr. Ursula Strate, Dr. Eberhard Barth and Dr. Ahmadi-Simab performed - if necessary in close cooperation with colleagues from Oncology and Functional Gastroenterology. After thorough preparation and under light sedation, the experts use state-of-the-art endoscopes and narrow-band imaging technology (NBI) to examine the entire large intestine up to the point where it joins the small intestine, taking tissue samples from suspicious areas to reliably assess whether an inflammation, a benign polyp or a tumor is present. Possible precancerous lesions are removed at the same time. The complete examination takes about 15-30 minutes, but preparation at home takes several hours. Follow-up care usually takes a maximum of one hour.
Our intestine - a fascinating organ
The intestine actually consists of two organs: While nutrients, salts and water are absorbed from food in the approximately five-meter-long small intestine, the so-called intestinal flora lives in the approximately 1.5-meter-long large intestine. It consists of an estimated 100 trillion bacteria that primarily process indigestible food residues and produce vitamins. The large intestine is divided into three parts: The first is the appendix, which contains the vermiform appendix. It plays an important role in the defense against germs, foreign substances and pathologically altered cells. It also serves as a retreat for beneficial bacteria when the intestinal mucosa is inflamed, so that they can later rebuild the intestinal flora. The largest part of the large intestine is the colon. It transports and mixes the intestinal contents with undulating movements, absorbing further nutrients and extracting water from the stool. In this way, it regulates the consistency of the stool. The last section of the colon is about 15 centimeters long and is called the rectum, rectum or rectum. With the help of the sphincters in the anal canal, it stores feces until the next bowel movement. Incidentally, the mucosal surface of the intestine measures about 500 square meters in total. In the course of a lifetime, the intestine processes around 30 tons of food and 50,000 liters of fluid.
