Krebsfruherkennung in der frauenarztlichen praxis: Aktuelle aspekte der wissenschaftlichen diskussion

Early cancer detection is one of the major tasks in the daily work of the gynecologist. In 1971, the directory for a public early cancer detection program was defined. Organ systems examined include the external and internal genitalia, the breasts, the skin, the rectum, and the colon. Methods applied include detailed anamneses, body exam, training for breast self-examination, Pap smear, and stool testing for blood. The use of mammography is restricted to women from families with multiple breast cancer cases or with previous breast alterations. In 2000, the knowledge about breast cancer incidence, morbidity and mortality, risk modulators and determinators, the definition of high risk groups, new detection methods, changes in therapies, and the focussing on quality of life with and without breast cancer have changed. Therefore, the focus and demand on the public early cancer detection program have to be adapted. At the same time, the health system's reduced finances direct towards maximum efficiency of the applied methods, the groups screened, and efforts for increasing compliance of women from high risk groups. Global screening does not seem to be applicable. Integration of risk assessment, information about prevention and prophylaxes, as well as motivation for participation could modify the established public early cancer detection program towards an individualized cancer care program.