Opinions differ wildly in Switzerland about the use of early cancer detection programmes. Some cantons are convinced that they save lives and offer their populations screening programmes across the board. Other cantons opt not to offer them.
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).
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.
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