Vienna launches free colorectal cancer screening: Up to 540,000 people to be invited

Mayor Michael Ludwig (SPÖ) described the launch as a milestone on Vienna's path to becoming the "prevention capital": "Mir ist es ein persönliches Anliegen, dass wir Wien zur Vorsorgehauptstadt machen. Mit dem heutigen Start des flächendeckenden Darmkrebs-Screenings ist uns ein weiterer Meilenstein dorthin gelungen." City Councillor for Health Peter Hacker stressed that the programme saves lives and reduces follow-up costs: "Durch dieses Screening werden Leben gerettet, Leid verhindert und letztlich auch teure Behandlungs- und Folgekosten gespart." Jing Hu, health spokesperson for Vienna's NEOS, also spoke of an important step towards earlier detection of diseases.

Reactions from politics and health insurers

Agnes Streissler-Führer, Chair of the regional committee of the Austrian Health Insurance Fund (ÖGK) in Vienna, pointed to the particular insidiousness of the disease: "Darmkrebs verursacht im Frühstadium oft keine Beschwerden." If the disease is detected early, the chances of recovery are high. A modern colonoscopy is now performed under a short anaesthetic, so that patients do not notice the examination itself – as the report puts it: "kriegen Sie ja davon nichts mit".

Despite these options, only a small proportion of those eligible currently take up the offer of a colonoscopy. As Margit Laufer reports, only 16 to 18 per cent of those eligible in Austria use the colonoscopy. For mammography screening, regular participation is 50 to 60 per cent according to the available data. Oncologist Dominik Wolf, Director of the University Clinic for Internal Medicine in Innsbruck, sees this as a structural deficit: Austria is "nicht wahnsinnig gut" when it comes to prevention.

Oncologist Wolf: Vienna as a signal for all of Austria

Wolf sees the Vienna model as a signal of supra-regional importance. He described the programme as a "wichtiges Instrument, auf die Menschen zuzugehen", and called the colonoscopy the "Goldstandard" of early detection. At the same time, he recommends the FIT test every two years as an alternative for those who are reluctant to undergo a colonoscopy. The risk of misdiagnosis in a comprehensive screening is "Viel geringer als die Gefahr, dass man durch fehlendes Screening Krebs nicht erkennt".

Specifically, Wolf names three classic risk factors: too little exercise, a low-fibre diet and high consumption of red meat. In clinical practice he sees many patients between 45 and 55 whose colorectal cancer is diagnosed too late: "Aber wir sehen in der klinischen Praxis viele Patienten und Patientinnen zwischen 45 und 55 mit Dickdarmkrebs, der zu spät diagnostiziert wurde." At this age, many people still feel invulnerable and take prevention less seriously.

Funding and organisation

As a personal barrier, Wolf cites the fear of the examination itself and the fear of the result: "eine Mischung aus der Angst vor der Untersuchung und auch der Angst vor dem Ergebnis". He too had to overcome his reservations before having a colonoscopy. Screening programmes have been shown to reduce mortality. Wolf hopes that the Vienna screening will serve as a pilot project to kick off a nationwide programme: "Wir haben hier viel zu tun, dieses Signal aus Wien ist ein wichtiges." Austria currently has no lung cancer screening programme.

The screening is organised in close cooperation between the City of Vienna, social insurance and the Vienna Medical Chamber. It follows the recommendations of the European Commission and the National Screening Committee. Funding is initially planned for two years and amounts to around 7.5 million euros per year, shared equally between the Vienna Health Fund and the health insurers. A central point of contact is the health advice line 1450, which also arranges telemedical consultations in the case of abnormal findings. In Austria, insured persons aged 25 and over are generally entitled to a colonoscopy every ten years.

The launch in Vienna is also being watched closely nationwide. A total of around 700,000 Viennese residents aged 45 to 75 are fundamentally eligible for regular prevention under the programme. If the model proves effective, it could become a template for expanding colorectal cancer prevention across Austria – a step that Wolf explicitly welcomes.