Preventive measures and preventive healthcare are useful for detecting illnesses at an early stage, identifying risk factors and preventing health problems. Regular check-ups allow potential health risks to be identified and treated in good time before they have serious consequences. This helps to improve quality of life, increase life expectancy and reduce overall healthcare costs. In Germany, most citizens have access to a wide range of preventive medical check-ups, which are financed by health insurance companies. These include health check-ups, skin cancer screening, bowel cancer screening, mammography screening and examinations for the early detection of cardiovascular diseases and diabetes.
However, despite the availability of these check-ups, not all German citizens make regular use of them. Participation rates in screening examinations vary depending on the type of examination and demographic factors such as age, gender and social status. Participation rates, for example colonoscopies as a preventive examination, can vary depending on the region and population group. According to data from the Robert Koch Institute (RKI), around a quarter (25.3%) of people aged between 50 and 54 underwent a colonoscopy for colorectal cancer screening in 2019. For people aged 55 to 59, the participation rate was around 26.5%. It is important that the frequency and necessity of these examinations are discussed individually with a doctor, based on age, gender, family history and other individual risk factors.
Detailed structure for the necessary preventive medical check-ups for men and women
1. general preventive medical check-ups
- Regular medical check-ups (every 1-2 years depending on age)
- Bio-impedance measurement (determination of body composition)
- Blood pressure measurement:
- Systolic blood pressure: The pressure in the arteries during heart contraction.
- Diastolic blood pressure: The pressure in the arteries between heartbeats.
- Normal range: systolic below 120 mmHg, diastolic below 80 mmHg.
- Blood test (see the list below)
2. examinations for women
- Cervical cancer screening (Pap smear)
- Breast cancer screening (mammography, clinical breast examination)
- Gynecological examination (examination of the external and internal genital organs)
3. examinations for men
- Prostate cancer screening (digital rectal examination, PSA test)
- Testicular cancer screening (self-examination of the testicles)
- Urological examination (examination of the external and internal genital organs)
4. specific examinations for both sexes
- Colonoscopy for colorectal cancer screening, possibly also gastroscopy
- Skin cancer screening (dermatological examination, reflected light microscopy)
- Cardiovascular screening (ECG, stress ECG, cardiac ultrasound)
- Pulmonary function test (spirometry)
- Thyroid examination (palpation, ultrasound)
- Ultrasound examination of the abdominal organs (liver, kidneys, spleen)
- Doppler sonography of the carotid artery (carotid Doppler)
- Eye examinations
5. possible radiological examinations
- CT thorax in smokers, MRI head (detection of aneurysms)
Important laboratory values that are used as part of preventive medical check-ups
- Differential blood count
- Cholesterol
- Total cholesterol: measure of the total cholesterol in the blood
- HDL cholesterol (high-density lipoprotein): "Good" cholesterol that reduces the risk of heart disease
- LDL cholesterol (low-density lipoprotein): "Bad" cholesterol that is associated with an increased risk of heart disease.
- Triglycerides: A type of fat in the blood that can also be linked to heart disease.
- Lipoprotein a determination if required
- Blood sugar
- Fasting blood glucose: The glucose level in the blood after a break of at least 8 hours from food.
- HbA1c (long-term blood glucose): A measure of the average blood glucose level over the last 2-3 months.
- Liver values
- Alanine aminotransferase (ALT): An enzyme that can indicate liver damage.
- Aspartate aminotransferase (AST): Another enzyme that can indicate liver damage.
- Gamma-glutamyltransferase (GGT): An enzyme that can indicate liver and bile duct diseases.
- Alkaline phosphatase
- Kidney values
- Creatinine: A breakdown product of muscle activity that can indicate kidney function.
- Urea: A degradation product of proteins that can also indicate kidney function.
- Electrolytes
- Sodium, potassium, chloride: electrolytes that influence the fluid and acid-base balance in the body.
- Uric acid
- Detailed urine analysis
- Iron status
- Ferritin: A protein that stores iron and can be helpful in the diagnosis of iron deficiency anemia.
- Inflammation markers
- C-reactive protein (CRP): A protein that can indicate inflammation in the body.
- Erythrocyte sedimentation rate (ESR): A measure of the rate at which red blood cells settle in a blood sample.
- Electrophoresis
- Vitamin D*
- Vitamin B 12 and folic acid
- Thyroid values
- Thyroxine (T4) and triiodothyronine (T3): Hormones that are produced by the thyroid gland and regulate the metabolism.
- Thyroid-stimulating hormone (TSH): A hormone that regulates thyroid function and can be helpful in the diagnosis of thyroid disorders.
In men, in addition to the general laboratory values, some specific values are important, especially in connection with prostate health. Here are some of them:
- PSA (prostate-specific antigen): PSA is a protein produced by the prostate. An elevated PSA level can indicate prostate cancer or other prostate diseases.
- Testosterone: Testosterone is the most important male sex hormone. A low testosterone level can cause symptoms such as reduced sex drive, lack of energy and depression.
The significance of these lab values may vary depending on individual health and other factors. It is important to discuss them with a doctor and understand their interpretation.
Notes on measuring the vitamin D level
*Measuring vitamin D levels can play an important role in screening, especially in regions with low sun exposure or in people at increased risk of vitamin D deficiency. Here are some reasons why vitamin D measurement may be relevant:
- Bone health: Vitamin D is important for the absorption of calcium and bone health. Low vitamin D levels can lead to weak bones and an increased risk of osteoporosis, especially in older people.
- Immune function: Vitamin D plays a role in the regulation of the immune system and can help to maintain the body's defenses against infections. A vitamin D deficiency can increase the risk of infections.
- Anti-inflammatory effect: Vitamin D has anti-inflammatory properties and can help to reduce inflammation in the body. Sufficient vitamin D levels can reduce the risk of inflammatory diseases.
- Muscle health: Vitamin D plays a role in muscle health and can support muscle strength and function. A lack of vitamin D can lead to muscle weakness and pain.
- Risk factors: People with an increased risk of vitamin D deficiency, such as older people, people with limited sun exposure (e.g. due to lifestyle or geographical location) or people with certain diseases, could benefit from having their vitamin D levels checked regularly.
Vitamin D measurement can help to detect a possible deficiency at an early stage and take appropriate preventive or treatment measures, such as taking vitamin D supplements or adjusting your diet and lifestyle to increase your vitamin D intake.
