During the stress ECG, Prof. Stefan Kääb from the LMU Hospital uses electrodes to measure a patient's cardiac action. © Andreas Steeger/LMU-Klinikum
People with statutory health insurance are entitled to a whole range of important early detection examinations. With us, top experts from various medical disciplines explain which doctor you need to see at what age and what you can do yourself.
You are never too old for retirement. For the head of the LMU Women's Clinic, the annual visit to the gynecologist is a must for all women: "This is an extensive anchor point and again and again the gynecologist also encounters other diseases, for example in the cardiovascular system," emphasizes Prof. Mahner, and adds: "I tell all patients that they have to go to the gynecologist every year until the age of 99 – and always jokingly add, that perhaps from the 100th birthday onwards we could talk about a two-year rhythm." Make sure you stay healthy. Cardiologist Professor Stefan Kääb from the Ludwig-Maximilians-Universität (LMU) Medical Center emphasizes: "Preventive medical check-ups are offers to maintain health. That's always better than treating disease." We explain the most important health tips and check-ups for three age groups: 18 to 35 year olds, 35 to 55 year olds and people aged 55 and over.
Retirement planning from 18 to 35 years: important for everyone
- Health in general: From the age of 18 to the age of 35, you should have a one-time, general check-up with your family doctor.
- Heart health: "The foundation for long-term health of the cardiovascular system is laid at a young age," says Professor Stefan Kääb, a cardiologist at the LMU Medical Center. That's why it's important to consider the following seven criteria: "The first important point is nutrition: The Mediterranean diet is recommended here – you should eat fresh ingredients and avoid industrially processed foods. The second crucial point is regular sufficient exercise, i.e. preferably 40 minutes of endurance training three to four times a week. Thirdly, you should not smoke, fourthly, you should know your own blood pressure and have it adjusted correctly if necessary. The fifth important point is to reduce excess weight if necessary. Sixth, everyone should know their LDL cholesterol level. The low-density lipoprotein is the unhealthy cholesterol. For people without risk factors for cardiovascular disease, an LDL cholesterol level below 116 mg/dl (<3.0 mmol/l) is considered the target value. The higher the risk, for example due to obesity, the lower the LDL cholesterol should be: For people with coronary heart disease or diabetes, the target value is below 55 mg/dl (1.4mmol/l). The seventh important point is blood sugar: have it checked once."
- Skin: "The be-all and end-all of prevention for the skin is sun protection," says dermatologist Dr. Christoph Liebich. In addition, you should keep a close eye on moles and go to the doctor immediately if one grows quickly, itches, bleeds or weeps.
- Dental health: Brushing your teeth regularly, not having sugar in your mouth too often and for too long are the most important points, says Prof. Hannes Wachtel, the founder of the Implaneo Dental Clinic in Munich. In order to harden the tooth enamel, he advises regular fluoridation, flossing and regular professional teeth cleaning at the dentist.
Preventive care from 18 to 35 years: important for women
- Gynecological cancer screening: "As the most important preventive measure against cervical cancer, girls, but also young women, should be vaccinated against HPV," says gynecologist Prof. Mahner. From the age of 20, a genital examination and cytological examination are scheduled once a year for the early detection of cancer. From the age of 30, an annual breast and skin examination is added to cancer screening. From then on at the latest, women should also regularly examine their breasts themselves.
Prof. Dr. Sven Mahner, head of the Women's Clinic at the Ludwigs-Maximilians-University of Munich, advises a patient. © Sigi Jantz
Retirement planning from 35 to 55 years: important for everyone
- Health check-up: From the age of 35, health insurance companies pay for the "health
check-up" with blood and urine test as well as a physical examination and blood pressure measurement for men and women every three years. For example, kidney and cardiovascular diseases, diabetes, high blood pressure, thyroid diseases, lipid metabolism disorders and autoimmune diseases can be detected at an early stage, explains Prof. Stefan Kääb. An ECG is also on the program. Within the check-up: Since autumn 2021, there has been a one-time screening for hepatitis B and hepatitis C virus infection. - Skin: From the age of 35, skin cancer screening by a dermatologist every two years.
- Dental health: Daily cleaning, also at least once, better twice a year to the dentist.
- Eyes: From the age of 30, glaucoma screening at the ophthalmologist.
Preventive care from 35 to 55 years: important for women
- At the gynecologist: From the age of 35, a combined screening of cytological examination and HPV test is on the agenda every three years. "Menopause usually occurs during this period," says Professor Mahner. For some women, this causes great discomfort, but hormone treatment can help here. This must be checked regularly so as not to increase the risk of breast cancer and stroke.
- Intestine: For the early detection of colorectal cancer, women aged 50 and over are tested annually for hidden blood in the stool.
- Breast: Every two years, women between the ages of 50 and 69 receive an invitation to mammography screening for the early detection of breast cancer.
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Prevention from 35 to 55 years: important for men
- Prostate: From the age of 45, annual cancer screening by palpation.
- Intestine: From 50 years of age, early detection examination of the intestine. "We know that men are more likely to get colorectal cancer than women, which is why screening is on the agenda for them earlier," explains Prof. Algül, Director of the Cancer Comprehensive Center (CCC) at the Technical University of Munich (TUM). In colorectal cancer screening, every man between the ages of 50 and 54 is entitled to an annual test for hidden blood in the stool. However, Prof. Algül prefers to recommend two colonoscopies ten years apart from the age of 50.
Prof. Hana Algül is the head of the Cancer Center CCC of the Klinikum rechts der Isar of the Technical University of Munich (TUM). © Astrid Schmidhuber
Retirement planning from the age of 55: important for everyone
- Dental health: In this age group, the problem of periodontitis is increasing, says dentist Prof. Hannes Wachtel: "Dental health studies show that 70 to 80 percent of the population show a prevalence of gingivitis, and you have to know that periodontitis could be prevented by 90 percent," says Wachtel. The inflammations can stubbornly settle in the so-called gum pockets. If it then gets into the jawbone, it is converted and degraded – with the bad consequence that the supporting apparatus of the teeth becomes unstable." All of this could be largely prevented by dental hygiene, emphasizes Prof. Wachtel. In addition to daily dental hygiene, he advises regular professional teeth cleaning by a dental hygienist. "Depending on the risk profile, I recommend visits to the dental hygienist in her dental practice every three to six months."
- Cardiovascular system: "Walk a lot, train your endurance, your stamina and your coordination," says Prof. Kääb. The "health check-up" every three years remains a must.
- Skin: In addition to annual skin cancer screening, it is important to keep the skin supple and well cared for. Above all, feet and legs should always be creamed, and the Munich dermatologist Dr. Liebich also advises the use of oil-based shower gels.
- Eyes: From the age of 60, early detection of age-related macular degeneration (AMD) by an ophthalmologist.
Preventive care from the age of 55: important for women
- Cancer prevention: For women, early detection of colorectal cancer is on the agenda from the age of 55. There are two options here: either a test for hidden blood in the stool is carried out every two years, or there are two colonoscopies at least ten years apart. Mammography every two years is also important," emphasizes Prof. Algül, because the risk of cancer increases with age. Even if a woman no longer has a uterus, he advises an annual visit to the gynecologist.
- Osteoporosis prevention: If you move a lot and do sports throughout your life, you are doing something for the stability of your bones in old age. If there is a risk of osteoporosis, Prof. Mahner advises a bone density measurement. And women should also take action in the case of continence problems so that they do not lead to women no longer doing sports, for example, the head of the Women's Clinic at the LMU Hospital recommends to women. "Even a small intervention can do a lot of good here," says Prof. Mahner. He also advises regular light strength training: "I've never met an elderly lady who complains about too much muscle mass, on the contrary."
Preventive care from the age of 55: important for men
- Ultrasound examination of the abdominal aorta: From the age of 65, men have a one-time right to an ultrasound examination for the early detection of aneurysms of the abdominal aorta.
This article contains only general information on the respective health topic and is therefore not intended for self-diagnosis, treatment or medication. It is in no way a substitute for a visit to the doctor. Unfortunately, individual questions about clinical pictures may not be answered by our editors.