Early detection examinations can help to limit the progression of a disease and, in particular, avoid expensive secondary diseases. The earlier a disease is detected, the more promising, faster and cheaper it can be treated and possibly even cured. Early detection with laboratory diagnostics offers concrete and objective test results so that behavioral changes can be effectively brought about and/or therapeutic measures can be taken.
Demographic developments and changes in the spectrum of diseases require healthcare provision to be designed with a stronger focus on effective preventive services. With this in mind, it is gratifying that the legislator has obliged the self-government to organize the early detection of colorectal cancer and cervical cancer as a regulated invitation procedure and to integrate modern laboratory diagnostics into it. Molecular diagnostics are now finally being used to search for the risk variants of the human papillomavirus (HPV), making cancer screening for women highly effective. The extent to which the use of early detection programmes is generally increased by an organized invitation procedure should be carefully evaluated.
Legislative requirements have been taken up elsewhere. However, the implementation by the self-administration partners does not go far enough. For example, the legislator has lowered the age limit for so-called health check-ups (Section 25 SGB V) from 35 to 18 years. The Federal Joint Committee then decided to include the diabetes check-up as part of the health check-up for the first time at the age of 18, and then again at the age of 35. It seems strange to agree on a time interval of 17 years for the diabetes check, given the increasing prevalence of diabetes, especially among younger people. In fact, such a decision bears the hallmark of minimizing expenditure. However, diabetes mellitus that is detected too late will be more expensive than regular early detection.
To promote prevention and early detection, measures such as the introduction of a screening bonus for insured persons, introduced with the Fairer Health Insurance Competition Act, are a good approach. Personal responsibility cannot be enforced, but it can be encouraged. This also includes understanding the insured person as an informed and responsible citizen. The overemphasis on supposedly negative benefit aspects ("false alarm") does not fit in with this understanding.
In order to increase the overall importance and use of early detection, the health check-up should be combined with an active approach, e.g. with an organized invitation procedure. This should also include measures that reach people in the workplace. Awareness of the health check-up can be appropriately accompanied by systematic public relations work. It is suggested that the capacities of the Federal Center for Health Education be integrated.