Guidelines for the Early Detection of Cancer

1. Breast cancer

• Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms (x-rays of the breast) if they wish to do so.
• Women age 45 to 54 should get mammograms every year.
• Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening.
• Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.
• All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening. They also should know how their breasts normally look and feel and report any breast changes to a health care provider right away.

Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRIs along with mammograms. (The number of women who fall into this category is very small.) Talk with a health care provider about your risk for breast cancer and the best screening plan for you.

2. Colon and rectal cancer and polyps

Starting at age 50, both men and women should follow one of these testing plans:

Tests that find polyps and cancer

• Flexible sigmoidoscopy every 5 years*, or
• Colonoscopy every 10 years, or
• Double-contrast barium enema every 5 years*, or
• CT colonography (virtual colonoscopy) every 5 years*

Tests that mostly find cancer

• Yearly guaiac-based fecal occult blood test (gFOBT)**, or
• Yearly fecal immunochemical test (FIT)**, or
• Stool DNA test (sDNA) every 3 years*

* If the test is positive, a colonoscopy should be done.

** The multiple stool take-home test should be used. One test done in the office is not enough. A colonoscopy should be done if the test is positive.

The tests that can find both early cancer and polyps should be your first choice if these tests are available and you’re willing to have one of them. Talk to a health care provider about which test is best for you.

If you are at high risk of colon cancer based on family history or other factors, you may need to be screened using a different schedule. Talk with a health care provider about your history and the testing plan that’s best for you.

3. Cervical cancer

• Cervical cancer testing should start at age 21. Women under age 21 should not be tested.
• Women between the ages of 21 and 29 should have a Pap test done every 3 years. HPV testing should not be used in this age group unless it’s needed after an abnormal Pap test result.
• Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called “co-testing”) done every 5 years. This is the preferred approach, but it’s OK to have a Pap test alone every 3 years.
• Women over age 65 who have had regular cervical cancer testing in the past 10 years with normal results should not be tested for cervical cancer. Once testing is stopped, it should not be started again. Women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing goes past age 65.
• A woman who has had her uterus and cervix removed (a total hysterectomy) for reasons not related to cervical cancer and who has no history of cervical cancer or serious pre-cancer should not be tested.
• All women who have been vaccinated against HPV should still follow the screening recommendations for their age groups.

Some women – because of their health history (HIV infection, organ transplant, DES exposure, etc.) – may need a different screening schedule for cervical cancer. Talk to a health care provider about your history.

4. Endometrial (uterine) cancer

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

Some women – because of their history – may need to consider having a yearly endometrial biopsy. Please talk with a health care provider about your history.

5. Lung cancer

The American Cancer Society does not recommend tests to check for lung cancer in people who are at average risk. But, we do have screening guidelines for those who are at high risk of lung cancer due to cigarette smoking. Screening might be right for you if you are all of the following:

• 55 to 74 years of age
• In good health
• Have at least a 30 pack-year smoking history AND are either still smoking or have quit within the last 15 years (A pack-year is the number of cigarette packs smoked each day multiplied by the number of years a person has smoked. Someone who smoked a pack of cigarettes per day for 30 years has a 30 pack-year smoking history, as does someone who smoked 2 packs a day for 15 years.)

Screening is done with an annual low-dose CT scan (LDCT) of the chest. If you fit the list above, talk to a health care provider if you want to start screening.

6. Prostate cancer

The American Cancer Society recommends that men make an informed decision with a health care provider about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. We believe that men should not be tested without first learning about what we know and don’t know about the risks and possible benefits of testing and treatment.

Starting at age 50, men should talk to a health care provider about the pros and cons of testing so they can decide if testing is the right choice for them.

If you are African American or have a father or brother who had prostate cancer before age 65, you should have this talk with a health care provider starting at age 45.

If you decide to be tested, you should get a PSA blood test with or without a rectal exam. How often you’re tested will depend on your PSA level.

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

• Stay away from all forms of tobacco.
• Get to and stay at a healthy weight.
• Get moving with regular physical activity.
• Eat healthy with plenty of fruits and vegetables.
• Limit how much alcohol you drink (if you drink at all).
• Protect your skin.
• Know yourself, your family history, and your risks.
• Get regular check-ups and cancer screening tests.