American Cancer Society - Cancer Screening Recommendations

Screening tests are used to help find cancer before a person has any symptoms. Screening can often help detect precancerous changes and cancers early, before they spread.

Here are the American Cancer Society's recommendations to guide you when talking to your doctor about screening for specific cancers:

Breast cancer

1. Women aged 40 to 44 should have the option to start annual breast cancer screening with mammograms (breast X-rays) if they wish.
2. Women aged 45 to 54 should have a mammogram every year.
3. Women aged 55 and older should have mammograms every two years or may continue annual screening.
4. Screening should continue as long as a woman is in good health and is expected to live for 10 more years or longer.
5. All women should know the known benefits, limitations and potential harms of breast cancer screening.
6. Women should also know how their breasts normally look and feel and report any breast changes to a healthcare provider immediately.

Some women should be screened with MRI scans as well as mammograms because of their family history, genetic predisposition or certain other factors. (Very few women fall into this category.) Talk to a healthcare provider about your breast cancer risk and determine the best screening plan for you.

Colon and rectal cancer and polyps

For people at average risk, the American Cancer Society recommends starting regular screening at age 45. This can be done with a sensitive test that looks for signs of cancer in a person's stool (a stool-based test) or an examination that looks at the colon and rectum (a visual examination). Talk to your healthcare provider about which tests may be good options for you and ask your insurance provider about your coverage. Whichever test you choose, the most important thing is to get screened.

If you are in good health, you should continue regular screening until age 75.

People aged 76 to 85 should discuss with their healthcare provider whether continuing screening is right for them. When making this decision, consider your preferences, overall health and previous screening history.

People over age 85 should no longer undergo colorectal cancer screening.

If you choose to be screened with a test other than colonoscopy, any abnormal test result should be followed up with a colonoscopy.

Cervical cancer

1. Cervical cancer screening should begin at age 25. People under age 25 should not be tested because cervical cancer is rare in this age group.
2. People aged 25 to 65 should have a primary HPV (human papillomavirus) test every 5 years. If primary HPV testing is not available, an HPV test with a Pap test (together with an HPV test) every 5 years or a Pap test every 3 years are still good options.

(A primary HPV test is an HPV test performed on its own for screening. The US Food and Drug Administration has approved certain tests for primary HPV testing.)

You should remember that the most important thing is to get screened regularly, whichever test you have.

1. People over age 65 who have had regular cervical cancer testing over the past 10 years should not be tested for cervical cancer.
2. Once testing has stopped, it should not be restarted. Those with a history of serious cervical precancer should continue to be tested even after age 65, even if testing extends beyond age 65.

Endometrial cancer

The American Cancer Society recommends that all women be informed about the risks and symptoms of endometrial cancer at menopause. Women should report any unexpected vaginal bleeding or spotting to their doctor.

Depending on their history, some women should consider an annual endometrial biopsy. Please talk to a healthcare provider about your history.

Lung cancer

The American Cancer Society recommends annual lung cancer screening with low-dose CT (LDCT) scans for:

1. People aged 50 to 80 who smoke or used to smoke
2. People with a smoking history of at least 20 pack-years

Before deciding to be screened, people should discuss the purpose of screening, how it is performed, and its benefits, limitations and potential harms with a healthcare professional.

1. People who still smoke should receive counselling on quitting and be offered interventions and resources to help.
2. People should not be screened if they have serious health problems that limit how long they are likely to live, or if they would be unable or unwilling to receive treatment even if lung cancer were found.

Prostate cancer

The American Cancer Society recommends that men make an informed decision with a healthcare provider about whether to be tested for prostate cancer.

Starting at age 50, men should talk to a healthcare provider to determine whether they should be tested.

If you are of African descent or your father or brother had prostate cancer before age 65, you should start discussing this with a healthcare provider at age 45.

If you decide to be tested, you should have a PSA blood test, or a rectal examination may be performed. How often you need to be tested will depend on your PSA level.

Take control of your health and help reduce your cancer risk.

1. Avoid tobacco use.
2. Achieve and maintain a healthy weight.
3. Stay active with regular physical activity.
4. Eat plenty of fruits and vegetables.
5. Drinking alcohol is not the best choice. If you do drink, limit your intake to no more than 1 drink per day for women or 2 drinks per day for men.
6. Protect your skin.
7. Know yourself, your family history and your risks.
8. Have regular health check-ups and cancer screening tests.