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In Germany, there are specific recommendations and examinations for various types of cancer.
January 27, 2026
Sophie Rodewyk
Detect cancer early, before it causes symptoms. What preventive examinations are recommended and when? What does the insurance cover? A guide.
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Every year, around 500,000 people in Germany are newly diagnosed with cancer – a diagnosis that fundamentally changes the lives of those affected and their relatives. But there is good news: If cancer is detected early, the chances of recovery for many types of cancer are over 90 percent. Breast cancer discovered at an early stage, for example, has a 5-year survival rate of 99 percent, while this drops to less than 30 percent in later stages.
Even people who lead an exceptionally healthy lifestyle repeatedly develop cancer. Medical cancer prevention or early detection is therefore, in addition to one's own careful observation of physical changes, the safest way to detect cancer early.
The numbers speak for themselves: Regular participation in early detection programs can reduce mortality from colorectal cancer by up to 60 percent, for example. Nevertheless, only about 50 percent of those entitled in Germany take advantage of the free preventive examinations – often due to fear, shame, or ignorance.
Even though there are now promising developments in research that suggest that cancer therapy could be revolutionized thanks to the advancement of mRNA technology, the rule remains: Prevention is better than aftercare. Cancer prevention remains essential for the timely diagnosis and treatment of cancer.
The basic rule is: Early stages can usually be treated more successfully and more gently. In Germany, there are specific recommendations and examinations for various types of cancer, which are covered by statutory health insurance – without co-payment and without bureaucratic hurdles.
Below, we have explained in detail the possible examinations for the five most common types of cancer and answer the most important questions about cancer early detection.
Starting at age 20, women are entitled to a Pap smear, which can be performed annually. From age 35, a combination of Pap smear and HPV test is offered, which can be repeated every three years.
The Pap smear is a painless examination that takes only a few minutes. The gynecologist uses a small brush or spatula to collect cells from the cervix. These cells are then examined in the lab for changes that could indicate a precancerous condition or a tumor.
The HPV test looks for human papillomaviruses, which are responsible for over 70 percent of all cervical cancer cases. The sample is taken along with the Pap smear—you won't feel anything extra.
Important warning signs that should prompt you to see a doctor outside of regular appointments:
An abnormal Pap smear does not automatically mean cancer. In most cases, it involves harmless cell changes that regress on their own. For abnormal findings, your doctor will:
The HPV vaccination is also a possible preventive measure to significantly reduce the risk of cervical cancer. Up to the age of 17, the costs for vaccinations for girls are covered in any case. However, some health insurance companies also offer cost coverage beyond this age limit. Since 2013, HPV vaccination has also been recommended for boys in Germany.
Breast cancer is the most common cancer among women in Germany, with around 70,000 new cases each year. About one in eight women will develop it in her lifetime. The good news: If detected early, the chances of recovery are very good.
Starting at the age of 30, women have the option to have an annual gynecological examination with palpation of the breast and regional lymph nodes. The gynecological examination should also include medical guidance for self-examination.
A monthly self-examination is recommended for women starting at the age of 20.
The best time for self-examination is about a week after the start of your period, when the breast tissue is less sensitive. Here's how to proceed:
From the age of 50, women are entitled to a mammogram offered every two years as part of the organized mammography screening program. Since July 1, 2024, the upper age limit of the program has been raised from 69 to 75 years.
About 3 out of 100 women receive an abnormal finding. This does not automatically mean breast cancer:
Skin cancer is the most common cancer in Germany – with a rising trend. About 270,000 new cases annually. The good news: Skin cancer is almost always curable when detected early.
From age 35, all insured individuals in Germany are entitled to skin cancer screening every two years, during which the entire skin is examined for noticeable changes.
The screening is painless and takes about 10-20 minutes.
You must undress completely, but the examination takes place in a protected room. It is best to wear little or no makeup and nail polish, as the face and nails will also be examined.
In addition to medical examination, self-monitoring of the skin for new moles or changes in existing skin lesions is crucial. It is advised to regularly watch for symptoms such as itching, redness, or sores.
What you should look out for (ABCDE rule):
Prostate cancer is the most common type of cancer among men in Germany. Annually, about 60,000 men receive this diagnosis. When detected early, the chances of a cure are very good – the 5-year survival rate is over 90 percent.
From the age of 45, men are entitled to an annual examination, which typically includes a palpation of the external genitalia, a digital rectal examination of the prostate, and an examination of the regional lymph nodes.
Many men avoid this examination out of shame or fear of pain. The reality:
The procedure:
Between annual examinations, you should see a doctor for the following symptoms:
Note: These symptoms usually occur only with advanced tumors. Early prostate cancer often causes no discomfort – that's why prevention is so important!
As an additional early detection, the so-called PSA test is recommended, although it is not routinely covered by health insurance companies.
What is the PSA test? The PSA test measures the concentration of prostate-specific antigen in the blood. An elevated level can indicate prostate cancer, but can also have other causes (benign prostate enlargement, inflammation).
Cost: 20-50 euros as an IGeL service
Controversy: The PSA test is controversial because it can lead to overdiagnosis. Discuss with your doctor whether the test is meaningful for you.
If prostate cancer is suspected, further examinations follow:
In Germany, colorectal cancer is the second most common cause of cancer death. However, colorectal cancer can be avoided in most cases with early detection, as it usually develops over years from benign precursors (polyps).
In Germany, women and men with statutory health insurance aged 50 and over are entitled to a one-time medical consultation about the possibilities of early colorectal cancer detection. Additionally, from age 50, an annual test for hidden blood in the stool can be performed using a quantitative immunological test (iFOBT).
The immunological stool test (iFOBT) is a simple method that you can perform at home:
Procedure:
What is measured: The test detects non-visible (occult) blood in the stool. Blood in the stool may indicate polyps or tumors, but often has harmless causes (hemorrhoids, anal fissures).
Important: A positive test does not automatically mean cancer; it is a recommendation for a colonoscopy for clarification.
From April 2025, women and men can use the same offers for colon cancer prevention. Until now, men aged 50 and women aged 55 were entitled to two free colonoscopies at 10-year intervals.
Another early detection colonoscopy can be performed after ten years.
Colonoscopy is considered the gold standard for early detection of colon cancer. Many people are afraid of it, but the examination is well tolerated thanks to modern technology:
Preparation (1-2 days before):
The examination itself:
After the examination:
Polyps are common and mostly harmless.
Colonoscopy is the only cancer screening that not only detects cancer early but also prevent can:
Cancer screening saves lives. Regular participation in early detection examinations significantly increases the chances of detecting cancer at an early, well-treatable stage. Early detected cancer means:
All screening examinations mentioned in this article are covered by statutory health insurance if you are within the recommended age and adhere to the prescribed intervals. There are no additional charges incurred.
Exceptions include:
You do not need a referral for preventive examinations. Simply make an appointment with your general practitioner or the relevant specialist.
Participation in cancer screening is completely voluntary in Germany. There is no obligation to undergo the examinations. However, participation is strongly recommended, as early detection can save lives.
The colonoscopy itself is usually not painful. Most patients receive sedation (light anesthesia) upon request, allowing them to sleep through the procedure. Without sedation, the procedure can be uncomfortable if air is pumped into the colon or curves in the colon are navigated. Many people find the preparation with the laxative more unpleasant than the procedure itself.
An unusual finding does not automatically mean cancer. In most cases, these are harmless changes or benign precursors. Your doctor will arrange further examinations to clarify the abnormality:
Even if it is cancer: The earlier it is detected, the better the chances of recovery.
Yes, you can cancel and reschedule appointments. There are no consequences from the health insurance. However, you should promptly make up for missed appointments to maintain your preventive protection. For mammography screening appointments, you will automatically receive new invitations if you do not attend an appointment.
For statutory early detection examinations, you usually do not need a referral. You can directly schedule an appointment with the relevant specialist:
A referral may only be necessary for further examinations after abnormal findings.
Yes, private health insurance also covers the costs for cancer early detection examinations, often even more extensively than statutory insurance. The exact benefits depend on your insurance plan. Please check with your insurer for specific regulations.
Health insurance usually covers the costs only at recommended intervals. If you wish to be examined more frequently, you generally have to bear the costs yourself (individual health services). Exception: If you have symptoms or an increased risk (e.g., family history), closer monitoring intervals may be medically necessary and thus covered by insurance.
The terms are often used synonymously, but they have different meanings:
Most "preventive examinations" are actually early detection screenings. Only the colonoscopy is true prevention because polyps are removed before they turn into cancer.
Yes, with many types of cancer, the risk increases if close relatives (parents, siblings) are affected. In this case:
Yes, cancer prevention does not offer 100% protection. Some tumors grow very quickly and are detected between examinations (interval cancers). Examinations can sometimes miss something. Nevertheless, participating in preventive examinations significantly reduces your risk of dying from cancer.
Cancer prevention is one of the most important measures for your health. Take advantage of the free services offered by public health insurance and regularly participate in the recommended examinations. Complement medical check-ups with self-examinations and pay attention to changes in your body.
The numbers speak for themselves: Cancer detected early is curable in most cases. Don't wait until symptoms appear – by then it is often too late for a gentle treatment.
Talk to your doctor about which preventive exams are personally advisable for you and when the next appointment is. It's best to schedule your next preventive examination today – it could save your life.
