Cancer Screening Guidelines

Cancer Screening Guidelines

These are the guidelines that we wish our patients to consider. Please talk to us during your yearly physical if you feel that these recommendations are right for you.

Colon Cancer Screening Guidelines

• People at average risk of colorectal cancer should start regular screening at age 45.

• People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75.

• People ages 76 through 85 should make a decision with their medical provider about whether to be screened, based on their own personal preferences, life expectancy, overall health, and prior screening history.

• People over 85 should no longer get colorectal cancer screening.

People at higher-than-average risk because of family history or personal history of colorectal cancer, certain types of polyps, certain colorectal diseases or syndromes, or personal history of radiation treatment to the abdomen or pelvis should talk to their doctor about a screening plan.

Cervical Cancer Screening Guidelines

• Cervical cancer testing (screening) should begin at age 25.

• Those aged 25 to 65 should have a primary HPV test* every 5 years. If primary HPV testing is not available, screening may be done with either a co-test that combines an HPV test with a Papanicolaou (Pap) test every 5 years or a Pap test alone every 3 years. 

(*A primary HPV test is an HPV test that is done by itself for screening. The US Food and Drug Administration has approved certain tests to be primary HPV tests.)

The most important thing to remember is to get screened regularly, no matter which test you get.

• Those over age 65 who have had regular screening in the past 10 years with normal results and no history of high-risk findings  or more serious diagnosis within the past 25 years should stop cervical cancer screening. Once stopped, it should not be started again.

• People who have had a total hysterectomy (removal of the uterus and cervix) should stop screening (such as Pap tests and HPV tests), unless the hysterectomy was done as a treatment for cervical cancer or serious pre-cancer. People who have had a hysterectomy without removal of the cervix (called a supra-cervical hysterectomy) should continue cervical cancer screening according to the guidelines above.

• People who have been vaccinated against HPV should still follow these guidelines for their age groups.

Some people believe that they can stop cervical cancer screening once they have stopped having children. This is not true. They should continue to follow American Cancer Society guidelines.

Breast Cancer Screening Guidelines

These guidelines are for women at average risk for breast cancer. For screening purposes, a woman is considered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, or a genetic mutation known to increase risk of breast cancer (such as in a BRCA gene), and has not had chest radiation therapy before the age of 30. (See below for guidelines for women at high risk.)

• Women between 40 and 44 have the option to start screening with a mammogram every year.

• Women 45 to 54 should get mammograms every year.

• Women 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.

• All women should understand what to expect when getting a mammogram for breast cancer screening – what the test can and cannot do.

Clinical breast exams are not recommended for breast cancer screening among average-risk women at any age.

Prostate Cancer Screening Guidelines

The American Cancer Society recommends that men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the possible benefits, risks, and uncertainties of prostate cancer screening. The discussion about screening should take place at:

• Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years

• Age 45 for men at high risk of developing prostate cancer. This includes African American men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65).

• Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age)

After this discussion, men who want to be screened should get the prostate-specific antigen (PSA) blood test.

The USPSTF (United States Preventive Services Task Force) does not recommend using digital rectal examination (DRE) as a primary screening test for prostate cancer. The evidence does not suggest significant benefits from DRE, and it was either eliminated from or not included in major screening trials

Lung Cancer Screening Guidelines

The American Cancer Society recommends yearly screening for lung cancer with a low-dose CT (LDCT) scan for people aged 50 to 80 years who:

• Smoke or used to smoke AND

• Have at least a 20 pack-year history of smoking

A pack-year is equal to smoking 1 pack (or about 20 cigarettes) per day for a year. For example, a person could have a 20 pack-year history by smoking 1 pack a day for 20 years, or by smoking 2 packs a day for 10 years.

People who still smoke should be counseled about quitting and offered interventions and resources to help them. People should not be screened if they have serious health problems that will likely limit how long they will live, or if they won’t be able to or won’t want to get treatment if lung cancer is found.