Bowel cancer screening

What is bowel cancer screening?

Bowel cancer screening is an examination that finds bowel cancer or its precursors before symptoms appear. The technical term is early detection of colon carcinoma. In Switzerland there are two recognised methods: the test for hidden (occult) blood in the stool and the bowel examination known as a colonoscopy. During a colonoscopy, a doctor examines the large intestine with a camera and can remove polyps straight away.

Bowel cancer screening is one of the medical prevention services paid for by basic health insurance. This is an exception: in principle, basic health insurance pays for the diagnosis and treatment of illnesses, and for prevention only where the ordinance expressly provides for it. Which preventive services these are is set out in the Health Care Benefits Ordinance (KLV).

It is important to distinguish screening from three other situations:

• Examination because of symptoms: if you have blood in your stool, abdominal pain or changes in your digestion, a colonoscopy is a normal examination of a possible illness. It is not covered by the screening rules but, like any treatment, with deductible and retention fee.
• Family risk: if bowel cancer runs in the family according to the KLV criteria, the insurer pays for a colonoscopy as early detection in a risk group, regardless of age.
• Supplementary insurance: some supplementary insurance products contribute to screening examinations that basic health insurance does not pay for. For bowel cancer screening from the age of 50, this is usually not necessary.

How it works

Between the ages of 50 and 74, you can choose between two options:

1. Stool test every 2 years: you do a test at home and the laboratory examines the sample for blood. If the test is positive, a colonoscopy follows, which is also paid for.
2. Colonoscopy every 10 years: you have a colonoscopy straight away. If the result is normal, the next screening is due after 10 years.

Where you have the examination determines the cost to you:

• In the cantonal screening programme: 16 cantons have organised programmes. If you have the examination as part of such a programme, the insurer charges no deductible. You still pay the 10% retention fee.
• Outside a programme: in cantons without a programme, or if you have the screening done directly by your doctor, the insurer also pays. However, the costs count towards the deductible, and above that you pay a 10% retention fee.

The KLV lays down exhaustively which cantons have a programme. As of 01.07.2026, they are Basel-Landschaft, Basel-Stadt, Bern, Fribourg, Geneva, Glarus, Graubünden, Jura, Lucerne, Neuchâtel, Solothurn, St. Gallen, Ticino, Uri, Vaud and Valais.

Legal basis

Art. 26 KVG requires basic health insurance to pay for certain examinations for the early detection of illnesses that are carried out or ordered by a doctor. Which examinations these are is determined by the KLV:

• Art. 12e let. d KLV (version in force since 01.07.2026): early detection of colon carcinoma between the ages of 50 and 74, either by testing for occult blood in the stool every 2 years (laboratory analyses according to the List of Analyses, colonoscopy if the result is positive) or by colonoscopy every 10 years. If the examination takes place in a screening programme of one of the 16 cantons listed, no deductible is charged.
• Art. 12d let. b KLV: colonoscopy for familial colon carcinoma if at least three first-degree relatives are affected or if one person fell ill before the age of 30.

The exemption from the deductible is based on Art. 64 para. 6 let. d KVG: the Federal Council can exempt prevention services provided as part of nationally or cantonally organised programmes from the deductible. This exception does not affect the retention fee. Its maximum of CHF 700 for adults is set out in Art. 103 KVV.

Example: the same colonoscopy in Bern and in Zurich

Markus, 55, has a deductible of CHF 2,500 and has had no medical costs so far this year. He decides to have a screening colonoscopy. For the calculation, we assume a bill of CHF 1,000; this is a value for the calculation, not a tariff. Two places of residence are compared: Bern (with a cantonal programme) and Zurich (not included in the KLV list).

What this means for you

• Plan from 50: talk to your GP about a stool test or a colonoscopy. Both options are covered by basic health insurance.
• Use the programme: if you live in one of the 16 cantons with a programme, have the screening done through the programme. Only then is the deductible waived.
• Consider your deductible: if you are planning a colonoscopy outside a programme, it is worth looking at your deductible. With a high deductible, you often pay for the examination in full yourself. The deductible calculator works out which deductible suits your expected costs; you can only change your deductible with effect from 1 January, see the dates under Deadlines.
• Mention your family history: if bowel cancer runs in your family, tell your doctor. The rules for risk groups then apply, even before the age of 50.
• Compare premiums: screening is covered in the same way by every insurer. The only differences are in the premium, which you can compare in the premium calculator. You will find key figures on the insurers under Health insurers.

Similar rules apply to mammography as part of cantonal programmes. How the deductible and retention fee work together is explained on the page on co-payment.

Common mistakes

• Believing screening is free. Even in the programme, you pay a 10% retention fee. Outside a programme, the bill also counts towards the deductible.
• Having screening done outside the programme even though one exists. The deductible then applies. Ask beforehand whether the examination is part of the cantonal programme.
• Trying to bill symptoms as screening. If you have symptoms, a colonoscopy is an examination of those symptoms. The age limits and intervals for screening then play no role, but neither does the deductible exemption.
• Forgetting the intervals. Stool test every 2 years, colonoscopy every 10 years: the insurer does not pay for more frequent screening without a medical reason as early detection.

We explain how we use statutory amounts in examples under How we calculate.