Screening Guidelines
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Screening Guidelines
For the Early Detection of Cancer
Site: Recommendation
Breast
  • Yearly mammograms are recommended starting at age 40. The age at which screening should be stopped should be individualized by considering the potential risks and benefits of screening in the context of overall health status and longevity.
  • Clinical breast exam should be part of a periodic health exam, about every 3 years for women in their 20s and 30s, and every year for women over 40 and older.
  • Women should know how their breasts normally feel and report any breast change promptly to their health care providers. Breast self-exam is an option for women starting in their 20s.
  • Women at increased risk (e.g., family history, genetic tendency, past breast cancer) should talk with their doctors about the benefits and limitations of starting mammography screening earlier, having additional test (i.e., breast ultrasound and MRI), or having more frequent exams.
Colon & Rectal

Beginning at age 50, men and women should begin screening with 1 of the examination schedules below:

  • A fecal occult blood test (FOBT) or fecal immunochemical test (FIT) every year.
  • A flexible sigmoidoscopy (FSIG) every 5 years*.
  • A double-contrast barium enema every 5 years.
  • A colonoscopy every 10 years.
Prostate

The PSA test and the digital rectal examination should be offered annually, beginning at age 50, to men who have a life expectancy of at least 10 years. Men at high risk (African American men and men with a strong family history of 1 or more first-degree relatives diagnosed with prostate cancer at an early age) should begin testing at age 45. For both men at average risk and high risk, information should be provided about what is known and what is uncertain about the benefits and limitations of early detection and treatment of prostate cancer so that they can make an informed decision about testing.
  
Uterus Cervix:  Screening should begin approximately 3 years after a woman begins having vaginal intercourse, but no later than 21 years of age. Screening should be done every year with regular Pap test or every 2 years using liquid-based tests. At or after age 30, women who have had 3 normal test results in a row may get screened every 2 to 3 years. Alternatively, cervical cancer screening with HPV DNA testing and conventional or liquid-based cytology could be performed every 3 years. However, doctors may suggest a woman get screened more often if she has certain risk factors, such as HIV infection or a weak immune system. Women 70 years and older who have had 3 or more consecutive normal Pap tests in the last 10 years may choose to stop cervical cancer screening. Screening after total hysterectomy (with removal of the cervix) is not necessary unless the surgery was done as a treatment for cervical cancer.

Endometrium:  The American Cancer Society recommends that at the time of menopause all women should be informed about the risks and symptoms of endometrial cancer, and strongly encouraged to report an unexpected bleeding or spotting to their physicians. Annual screening for endometrial cancer with endometrial biopsy beginning at age 35 should be offered to women with or at risk for hereditary nonpolyposis colon cancer (HNPCC).
  
Cancer Related Checkup For individuals undergoing periodic health examinations, a cancer -related checkup should include health counseling, and, depending on a person's age and gender, might include examinations for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries, as well as for some nonmalignant diseases.
  
  Information taken from the American Cancer Society Guidelines, © 2005.

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