What each test is worth
The same question for each: per 1,000 people, how many deaths from the disease does the test prevent? Some numbers come from trials (people invited, or randomly assigned to the test), others from a model that assumes people always attend; each has its own time span, written beside it. For osteoporosis the number is hip fractures, not deaths. So the tests are not ranked on one scale.
Each small square is a person; there are 10,000.
High blood pressure, which causes no symptoms and raises the risk of heart attack and stroke.
no death count for the test
No trial compares people whose blood pressure was measured with people whose was not. The benefit comes from treatment, which clearly cuts heart attacks and strokes.
HIV infection, which treated in time means a near-normal lifespan.
no death count for the test
The benefit comes from starting treatment early; no death count has been measured for the test itself.
What insurance pays
Anonymous at the local health office (Gesundheitsamt), free or for a small fee, and at community checkpoints; your doctor's test is covered by insurance when there is a concrete reason.
Deutsche Aidshilfe, HIV-Test
Invisible traces of blood in stool, a sign of polyps and bowel cancer. A positive test leads to a colonoscopy, where polyps can be removed there and then.
24–28 per 1,000
bowel cancer deaths avoided per 1,000 people screened from 45 to 75, modelled estimate (US)
modelled estimate
The model assumes a FIT every year (or a colonoscopy every 10 years) from 45. The programme here, every 2 years from 50, prevents somewhat fewer deaths.
What the rules provide
From 50, women and men choose: a stool test (FIT) every 2 years, or two colonoscopies 10 years apart. Since April 2025 women can have the colonoscopy from 50, like men.
G-BA, Darmkrebs-Screening
What insurance pays
Free. Your insurer invites you at 50, 55, 60 and 65. The stool test comes from your family doctor or gynaecologist; the colonoscopy is done by a gastroenterologist.
G-BA, Darmkrebs-Screening
A swelling of the main artery in the abdomen that causes no pain and no signs until it bursts.
4.6 per 1,000
aneurysm deaths prevented per 1,000 men invited to one scan, over 13 years (MASS trial)
measured in a trial
In December 1948 the surgeon Rudolph Nissen opened Albert Einstein's abdomen in Brooklyn and found a large aneurysm on the aorta. There was no way to replace it, so he wrapped it in cellophane to stiffen it. Einstein lived six more years. In April 1955 the aneurysm burst; he refused surgery and died on 18 April. Today the same swelling shows up on a scan that takes a few minutes.
PSA test for prostate cancer
from 45, on request
Prostate cancer, including many small tumours that would never have caused harm.
2.2 per 1,000
prostate cancer deaths prevented per 1,000 men aged 55–69 invited to PSA testing, over 23 years (ERSPC)
measured in a trial
More than 45% of men tested at every round had at least one false positive over 10 years, and 20–50% of the cancers found would never have caused harm.
Your chance of a heart attack or stroke in the next 10 years, worked out from cholesterol, blood pressure, age and smoking.
no death count for the test
The benefit comes from treatment: in 18 trials of adults with no previous heart attack or stroke, statins meant about 3.5 fewer deaths per 1,000 people treated, over 6 months to 6 years.
Type 2 diabetes and prediabetes, which can go years without signs.
no death count for the test
Screening trials found no fewer deaths over 10 years. The test is worth it if something changes afterwards: diet, activity, treatment.
Viruses that damage the liver silently for decades, up to cirrhosis or cancer. Hepatitis C is now cured with tablets in 8–12 weeks.
no death count for the test
No death count has been measured for the test itself. The benefit comes from treatment: hepatitis C is cured in over 95% of people treated.
Skin cancer check
from 35, every 2 years
Melanoma and other skin cancers, through an examination of all your skin, scalp included.
no death count for the test
No trial has shown fewer melanoma deaths from checking the skin of people without symptoms; the checks do find many spots that lead to biopsies.
What insurance pays
Free with statutory insurance (GKV): a dermatologist or a trained family doctor (Hausarzt) looks at all your skin, scalp included. The doctor may use a dermatoscope; since April 2020 it is part of the insured service and may not be charged separately.
G-BA, Krebsfrüherkennungs-Richtlinie (Fassung 18.12.2025)
High-risk types of HPV, which over years can turn cells of the cervix into cancer. A positive test leads to a check of the cells and, if needed, a colposcopy, where changes are found before they become cancer.
8 per 1,000
cervical cancer deaths avoided per 1,000 women with an HPV test every 5 years from 30 to 65, compared with none: from 8.34 to 0.29 (modelled estimate, US)
modelled estimate
What the rules provide
From 20 to 34, a Pap smear every year; from 35, a Pap smear together with an HPV test every 3 years, with no upper age limit.
G-BA, Gebärmutterhalskrebs-Screening
Breast screening (mammogram)
50–75, every 2 years
Breast cancer while it is small, before it can be felt.
4.3 per 1,000
breast cancer deaths prevented per 1,000 women invited from 50, over 20 years
estimated from 11 trials
12.9 cancers found that would never have caused harm (overdiagnosis)
Lung scan (low-dose CT) for smokers
50–75, every year
Lung cancer at a stage when it can still be operated on.
3 per 1,000
lung cancer deaths prevented per 1,000 heavy smokers scanned yearly, over about 7 years, compared with chest X-ray (NLST)
measured in a trial
Nearly a quarter of scans come back positive at first; almost all turn out to be false alarms.
What the rules provide
Since April 2026: a low-dose CT scan every year from 50 to 75 for current and former heavy smokers, with at least 25 years of smoking, at least 15 pack-years, and smoking breaks (a quit included) of no more than 10 years.
G-BA, Lungenkrebs-Screening
What insurance pays
Free with statutory insurance. A participating family doctor or internist checks whether you qualify and talks it through; an approved radiology practice does the scan.
G-BA, Lungenkrebs-Screening
Osteoporosis: bones that break in an ordinary fall.
5 per 1,000
hip fractures prevented per 1,000 older women, over 4–5 years (three trials)
measured in trials
What the rules provide
No screening programme. Bone density measurement is paid when there is a specific reason: a fracture without major trauma, or a raised risk where the result would decide on treatment.
What insurance pays
With a specific reason, free on referral; purely as a check-up, it is usually a self-paid extra (IGeL).
Common questions
Which screening does statutory health insurance pay for in Germany?
Statutory insurance (GKV) pays for: the Check-up once between 18 and 34 and every 3 years from 35 (blood pressure; from 35 also cholesterol, blood sugar and a one-time hepatitis B and C test); cervical screening from 20; a skin check every 2 years from 35; a mammogram every 2 years from 50 to 75; a stool test every 2 years or two colonoscopies from 50; a rectal examination for men from 45; one aortic scan for men from 65; and, since April 2026, a yearly lung CT for heavy smokers from 50 to 75.
Which check-ups should you have at 40?
Women: Cervical screening, Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, Hepatitis B and C, one-time test, Skin cancer check, HIV, one-time test. Men: Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, Hepatitis B and C, one-time test, Skin cancer check, HIV, one-time test.
Which screening should you have from 50?
Women: Cervical screening, Breast screening (mammogram), Bowel cancer screening (FIT kit), Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, Hepatitis B and C, one-time test, Skin cancer check, HIV, one-time test. Men: Bowel cancer screening (FIT kit), Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, Hepatitis B and C, one-time test, Skin cancer check, HIV, one-time test. The PSA test is self-paid (IGeL) and a decision to make with your doctor. Heavy smokers from 50 to 75 add a yearly low-dose lung CT.
Which screening should you have from 65?
Women: Cervical screening, Breast screening (mammogram), Bowel cancer screening (FIT kit), Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, Hepatitis B and C, one-time test, Skin cancer check, HIV, one-time test. Men: Bowel cancer screening (FIT kit), Abdominal aortic aneurysm (AAA) scan, Blood pressure, Cholesterol and 10-year heart and stroke risk, Blood sugar test for diabetes, Hepatitis B and C, one-time test, Skin cancer check, HIV, one-time test. The PSA test is self-paid (IGeL) and a decision to make with your doctor. Heavy smokers from 50 to 75 add a yearly low-dose lung CT.
Are self-paid extras (IGeL) worth it?
Mostly not. The independent IGeL-Monitor rates ovarian ultrasound 'negative', and the PSA test, thyroid checks and glaucoma eye-pressure tests 'tends to be negative'. A Cochrane review of 17 trials found general health checks made no difference to deaths. What matters is the screening that fits your age, which insurance already pays for.
Ready-made lists
The list at 25, woman · The list at 25, man · The list at 30, woman · The list at 30, man · The list at 40, woman · The list at 40, man · The list at 50, woman · The list at 50, man · The list at 60, woman · The list at 60, man · The list at 70, woman · The list at 70, man
How the list was made
The evidence column follows the directives of the Federal Joint Committee (G-BA), which decide what statutory health insurance (GKV) pays for, and the German cancer information service (Krebsinformationsdienst). The size of each benefit comes from the randomised trials and the US Preventive Services Task Force evidence reviews. Private insurance (PKV) usually pays for the same tests, with its own rules.
Lives saved are absolute: deaths avoided per 1,000 people, not '42% fewer'. Some come from trials (people invited, followed for a fixed number of years), others from models that assume you take every test for life. They are labelled separately and not ranked.
This page does not replace your doctor. With symptoms, a family history of cancer or a long-term condition, your list is different and is made with them.