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What is important for our health? How do we know what is good for us? Where do we get advice regarding our health? All of us should be concerned about our health. Our health literacy is an important guide to living a health-enhancing life. To build up this literacy we need access to health information that is easy to understand.

There is no shortage of information sources, but in these days of social media and the internet it is often difficult to judge the quality of the information that is available. All the more reason to give people access to up-to-date scientific and objective information presented in a way that is simple and easy to understand: which early detection screens and programmes make sense? What are the advantages and disadvantages of the medical programmes on offer? As it is often impossible to provide general answers to medical questions, transparent and reliable information is important.

As the leading health insurer in Switzerland we want to make sure that our customers have access to independent, easy-to-understand information to help them take the right decisions. You can make up your own mind about important health topics and decide more easily what is right and important for your health. This is our commitment to making a contribution to your health – in the interests of providing sustainable healthcare.

To start with, we have selected three early detection measures: mammogram, PSA and colon cancer screening. The facts presented in cooperation with the Harding Center for Risk Literacy are based on systematic screening results. This means that these facts refer to the systematic screening of broad sectors of the population who did not exhibit any specific symptoms of disease. In individual cases (if the patient suffers from a complaint or is exposed to individual risk factors), it can be quite sensible to do an early detection screen. Experts refer to such cases as “opportunistic screening”.

PSA screening for early detection of prostate cancer

The PSA (prostate-specific antigen) test is a simple blood test that measures the levels of a protein that is only produced by the cells of the prostate gland in a man's blood. A PSA level that is too high points to a problem with the prostate. Although a high PSA level can indicate prostate cancer, there can also be other reasons for a high PSA result. To help you weigh the benefits and risks of a PSA test for the early detection of prostate cancer, we compiled the facts and an overview of the most important advantages and disadvantages in collaboration with the Harding Center for Risk Literacy.

Five long-term studies were carried out during which thousands of men over 50 either did or did not do regular PSA tests. The figures refer to groups of 1,000 men older than 50 who regularly did PSA tests over an observation period of 11 years (screening group) and a group consisting of the same number of men who did not participate in any screening (comparison group).

Long-term studies on early detection of prostate cancer
PSA-Screening

The assessment of the scientific results shows that PSA screening did not reduce the number of men who died from prostate cancer during this period of 11 years. The number of men who died from prostate cancer was the same for both groups: 7 out of 1,000 men died from prostate cancer. In summary, the PSA test did not have any impact on the mortality rate. In the observation period of 11 years, a biopsy based on misleading PSA test results was done on 160 of 1,000 men in the screening group. Twenty out of 1,000 men in the screening group were misdiagnosed and wrongly treated for prostate cancer.

More information:

In its report of 31 October 2011 the Swiss Medical Board stated that tests to measure the PSA levels of men who do not exhibit any symptoms are not justified. To the report in German >

Mammogram for early detection of breast cancer

A mammogram is an X-ray examination of the breasts of women from the age of 50 in an attempt to detect breast tumours as early as possible, thus improving the chances of healing. But what are the real benefits of a mammography exam, and what possible damage can be done?

As it is often impossible to provide general answers to medical questions, transparent and reliable information is important. To help you weigh the benefits and risks of a mammogram, we give the facts here, in collaboration with the Harding Center for Risk Literacy. A well-structured overview is provided of the most important advantages and disadvantages.

Long-term studies were carried out during which thousands of women over 50 either did or did not undergo regular screening. The figures refer to women older than 50* who participated in mammography screening for 10 years or more (screening group) and a group consisting of the same number of women who did not participate in any screening (comparison group).

Long-term studies on early detection of breast cancer

Brustkrebs-Screening
The assessment of the scientific results shows that regular mammograms reduced the number of women who died from breast cancer in a period of 10 years from 5 to 4 women out of 1,000. This did not have any impact on the total cancer mortality rate: in both groups, the same number of women died from cancer during this period.

Out of 1,000 women in the screening group, 100 women had at least one abnormal result in 10 years, although it was confirmed later that they did not have breast cancer. Some of these women had to live with uncertainty for many months and submit to further diagnostic tests until they could be confirmed to be healthy.

Mammograms also detect “indolent” tumours (tumours that grow slowly or are less aggressive) that never develop into life-threatening cancer. As the development of indolent or life-threatening tumours cannot be predicted, 5 out of 1,000 women in the screening group underwent partial or total mastectomy, even though this was unnecessary.

In Switzerland the compulsory health insurance pays for mammography screening. In some cantons running cantonal detection programmes, no deductible is payable.

More information:

The Swiss Medical Board did not favour the introduction of a systematic mammography screening programme in its report of December 2013, and recommended giving patients a thorough medical check-up and information on the positive and negative effects before doing any kind of mammogram: To the report (in German) >

Colonoscopy for early detection of colon cancer

There are two types of colonoscopy: a small one and a big one. In many European countries only a small colonoscopy is done (also known as sigmoidoscopy), but in Switzerland it is usual to do a “big” colonoscopy (also known as coloscopy). The procedure is similar to a sigmoidoscopy, but the examination goes further. Both tests examine the inside of the colon with a flexible tube inserted into the colon. With both methods the doctor can directly remove suspected cancer lesions discovered in the colon during the examination.

The faecal occult (hidden) blood test is another early detection screen for colon cancer.

Are these early detection screens useful? It is often impossible to provide general answers to medical questions, and this is also true here. Transparent information is important. To help you weigh the benefits and risks of a colonoscopy, we give the facts here, in collaboration with the Harding Center for Risk Literacy. A well-structured overview is provided of the most important advantages and disadvantages.

The figures refer to people older than 50 who did at least one colonoscopy over an observation period of 10 years (screening group) and a group consisting of the same number of people who did not participate in any screening (comparison group).

Long-term studies on early detection of colon cancer
Darmkrebs-Screening

The assessment of the scientific results shows that out of every group of 1,000 people who did a sigmoidoscopy for the early detection of colon cancer, 6 people died from colon cancer over a period of at least 10 years. In the group that did not take part in the screening, 8 out of 1,000 people died from colon cancer over the same period. This did not, however, have any impact on the total mortality rate: in both groups, the same number of people died during this period. By removing cancer lesions during early detection screening, 4 people from the screening group of 1,000 people were saved from a diagnosis of colon cancer.

Out of 1,000 people taking part in early detection screening for colon cancer, 200 suffered from medium to strong pain or complaints. Out of 1,000 people taking part in early detection screening for colon cancer, less than one person suffered from serious complications (e.g. strong colon bleeding or a tear in the colon).

The compulsory health insurance (OKP) covers the costs of a colonoscopy even if the person being examined does not have any family history of colon cancer. The insurance covers the test for blood in the stool (every two years) and a coloscopy (every 10 years) for men and women between the ages of 50 and 69. No deductible is payable on coloscopies done as part of screening programmes in the Cantons of Vaud and Uri.