On World Cancer Day on 4 February 2021: Women less likely to have early cancer detection

02.02.2021 10:23

During the first wave of coronavirus, there were fewer screening tests for cervical cancer: According to an analysis by the Techniker Krankenkasse (TK), around 26 percent of eligible TK-insured women attended a screening appointment in the first half of 2020 – about a fifth less than in the first half of 2019 (32 percent).

"It's not yet possible to say how strong the catch-up effects will be in the second half of 2020. Women may have postponed their check-up appointments with their gynecologist until after the first wave of the pandemic," explains Ulrich Kosel, an expert at TK for early cancer detection. Figures on this will not be available until early summer.

Organized screening program since the beginning of 2020

But coronavirus isn't the only thing that may have influenced the uptake of early cancer screening. Ulrich Kosel of TK: "As of January 1, 2020, the legislature revised the regulations for regular cervical cancer screenings and launched an organized screening program." After that, women between 20 and 34 years of age will continue to be screened annually using a Pap test. Women aged 35 and over will no longer be offered the Pap test annually, but every three years – then additionally combined with a test for certain viruses (HPV testing). For both tests, a smear is taken from the cervix and examined in the laboratory. The Pap test examines cell changes that are considered precursors to cancer. HPV viruses, in turn, increase the risk of such cell changes.

Three-year interval corresponds to the reality of many women

The combination of Pap and HPV tests for women 35 and older ensures more reliable test results and, thanks to the new three-year interval, reduces the amount of time required for doctor visits. Ulrich Kosel of TK: "In fact, up to now, only one in four women regularly attended the annual screening test. The majority attend less frequently." A TK analysis has shown that, on average, over four years, three out of four eligible women attended at least one screening appointment." The new three-year interval thus appears to be more in line with the realities of many women's lives.

Personal invitations by mail for the first time

Women between the ages of 20 and 65 now also receive regular mail from their health insurance company every five years. This mailing includes a personal invitation with information about early cancer screening. A reminder is sent every five years. TK expert Ulrich Kosel: "The earlier cancer and precancerous lesions are detected, the better the chances of recovery." Since the beginning of the written invitation process for cervical cancer screening in early 2020, TK has sent around 861,000 letters to its insured members aged 20 to 65.

Cervical cancer: an average of 4,500 cases per year nationwide

Nationwide, approximately 4,500 women develop cervical cancer each year. The primary cause is sexually transmitted human papillomavirus (HPV). Infections with these viruses can lead to cellular changes and ultimately malignant tumors. These cellular changes usually occur over years and often develop from precancerous lesions. Precancerous lesions appear on average at the age of 34, while cervical cancer develops at the average age of 55. TK refers to information from the German Cancer Society.

HPV vaccination can protect, but does not replace early detection

The Standing Committee on Vaccination recommends that 9- to 14-year-old girls and boys be vaccinated against HPV, or that they receive this vaccination before their 18th birthday at the latest. TK covers the costs. The vaccination does not protect against all high-risk HPV viruses. Therefore, it does not replace early detection.