Early cancer detection

a laboratory employee examines contents of a test tube

Source: © Volker Wiciok, Lichtblick

The early detection of occupational diseases – which include cancer – is an important element of secondary prevention.

Occupational cancers are one of the greatest challenges in the field of occupational medical prophylaxis. As a result of the long latency periods that accompany the diseases in question, cases continue to arise despite enormous improvements in the field of occupational health and safety (OSH). Causal exposure to carcinogenic substances often occurred a number of decades ago at a time when insufficient knowledge was available on many hazardous substances.

Many cancers are no longer at an early stage when diagnosable symptoms become apparent. The aim of early cancer detection is therefore to maximize the chance of successful tumour treatment by ensuring diagnosis at the earliest possible stage.

Available classical methods of early diagnosis often do not identify the development of new cancerous growth at an early enough stage. Although computer tomograph (CT) examination of the lungs facilitates the detection of even the smallest examples of the most common occupational cancer (lung carcinoma), CT examination is itself accompanied by stress and therefore only to be used on a regular basis if absolutely necessary. The potential importance of CT to mesothelioma diagnosis is currently being investigated by the Institute of Occupational Medicine and Environmental Medicine (IASA) at Aachen University Clinic in cooperation with the DGUV and its members.

There is nevertheless justified hope that current advances in the field of biomedical research will lead to novel early detection methods in the future. So-called “molecular markers” represent both an alternative and useful addition to conventional procedures. Molecular markers are bodily substances which tumours produce on an increased or modified basis before releasing them (for example into the bloodstream). It is therefore possible to extract them non-invasively from blood samples – or depending on the location of the tumour, urine, sputum or similar bodily fluid samples – and identify them using modern, laboratory-based molecular-biological procedures. From the patient’s perspective this type of method would represent a far less stressful approach to cancer detection.

Though a number of new, highly promising molecular markers targeted at diseases such as bladder cancer and mesothelioma are already available, there is a need for them to be validated within the framework of larger-scale, prospective (i.e. future-oriented) studies. The aim here is to ensure that they are suitable for use and effective in practical scenarios. Two ongoing studies led by the Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA) at the Ruhr University in Bochum and involving numerous domestic and international cooperation partners focus on the testing of numerous markers on both an individual basis and in combination as part of the early detection of cancerous diseases.


Dr. rer. nat. Georg Johnen
Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA)
Center of Molecular Medicine
Tel.: 0234 302-4509

 Prof. Dr. Thomas Behrens
Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA)
Tel.: 0234 302-4794