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Early detection tests in Germany: Uterus

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Women’s health is a great deal in Germany. Uterus tests are encouraged and mosts tests are covered by the insurance. Find out the types of tests women can expect in Germany

What does the health insurance in Germany pay? What kind of provision makes sense, but has to be paid for privately? Below are the most important early detection tests for the uterus that women get in Germany.

Pap test for early detection of cervical cancer

uterus

Who / When 

Women between 20 and 34 years of age, once a year; From 2020, women aged 35 and over will be offered a combination of Pap test and HPV test every three years.

Examination

The doctor feels the genital organs through the abdominal wall and examines the cervix with the so-called speculum (reflection). 

To check for cancer cells and precursors, he / she takes a swab from the mucous membrane on the cervix and the outer edge of the cervix. The cells removed are examined for changes under the microscope (Pap test).

Are they useful? 

The Pap test detects suspicious cell changes at an early stage, which occur in women especially in the ages 35-39 and 60-69 years. They are usually triggered by chronic inflammation with the cancer-causing human papillomavirus (HPV). 

The uterus test is criticized because it often gives false-positive results, i.e. a positive test result even though there are no dangerous cell changes. Nevertheless, since its introduction, the test has been shown to improve women’s chances of survival. 

It is therefore more questionable whether the newer HPV test should replace the Pap test. European studies have already shown that a combination of the tests protects more women from cervical cancer than the Pap test alone.

What are the costs? 

The smear is paid for by the statutory health insurance as part of the free cancer screening: women between the ages of 20 and 34 can have a Pap smear every year; For women over 35 years of age, the health insurers take over the combined test (HPV and Pap test) every three years.

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HPV test for early detection of cervical cancer

uterus

Who / When

women aged 30 and over, every five years; Women aged 35 and over have been offered a combined Pap test and HPV test every three years since 2020.

Examination

As with the Pap smear, cells are taken from the mucous membrane on the cervix and the outer edge of the cervix (smear). In contrast to the Pap test, the cells are examined in the laboratory in the HPV test for the DNA of HP viruses.

Are they useful? 

Studies around the world indicate the usefulness of the uterus test. For example, in the Netherlands, Italy, Sweden or Great Britain, the test has been used for a long time for prevention. In Wolfsburg, two health insurances are offering it in a pilot project. The test makes sense, however: Here, too, there is a relatively high chance of false-positive results.

What are the costs? 

The HPV test is available everywhere in Germany as an IGeL service from the gynecologist and costs between 50 and 80 euros. The combined test (HPV and Pap test) has been part of the statutory provisions since 2020 and is covered by the health insurers every three years for women aged 35 and over.

Chlamydia screening

uterus

Who / When

Women up to 25 years of age, annually

Examination

In chlamydia screening, chlamydia bacteria are detected using a urine sample. In women, these can cause severe inflammation of the uterus and fallopian tubes and also cause cell changes (cancer).

Are they useful? 

The investigation makes sense – chlamydia are the world’s most common pathogen of sexually transmitted diseases and, according to experts, also the most common cause of unwanted infertility in women. Untreated chlamydial infection can lead to an ectopic pregnancy, premature birth, or miscarriage in pregnant women.

What are the costs? 

The chlamydia screening is paid annually for sexually active women up to the age of 25 by the statutory health insurance. The health insurers also take over the chlamydia test for pregnant women as part of the preventive medical check-up in the 1st to 3rd month of pregnancy.

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