The American Cancer Society’s Guidelines for the Early Detection of Cancer
Screening tests can help find cancer before a person has any symptoms. Detecting cancer at an early stage can mean treatment is more effective. For people age 20 or older who get periodic health exams, a cancer-related check-up should include health counseling and, depending on a person’s age and gender, exams for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries, as well as for some other diseases besides cancer.
The American Cancer Society recommends the following breast cancer screening guidelines for women of average risk and without symptoms:
- Women ages 40 to 44 should have the choice to start annual breast cancer screenings with mammograms 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 and limitations linked to breast cancer screening. They should know how their breasts normally look and feel and report any changes to a health care provider right away.
- Women at high risk for breast cancer – because of a personal or family BRCA1 or BRCA2 gene mutation, radiation to the chest between the ages of 10 and 30 years, or other factors – should have an annual MRI in addition to a mammogram. Women at increased risk – because of a family history or personal history of breast cancer, or who have extremely dense breast tissue when viewed on mammograms – should discuss with their doctor the benefits and limitations of adding MRI to their annual mammogram. Women at high or increased risk for breast cancer should talk to their doctor about their history to determine when to begin screening.
The American Cancer Society recommends cervical cancer screenings for women starting at age 21. Younger women should not be tested.
- Women between the ages of 21 and 29 should have a Pap test done every three years. HPV testing should not be used in this age group unless it’s recommended 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”) every five years. This is the preferred approach, but it’s OK to have a Pap test alone every three years.
- Women over the age of 65 who have had regular cervical cancer testing with normal results for the past 10 years 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 continues past age 65.
- A woman who has had her uterus and cervix removed for reasons not related to cervical cancer and who has no history of cervical cancer or serious pre-cancer should not be tested.
- A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group.
- Some women, because of their health history (HIV infection, organ transplant, DES exposure, etc.), may need an alternative screening schedule for cervical cancer. Talk to a doctor or nurse about your history.
In the United States, cancer of the endometrium is the most common cancer of the female reproductive organs. Most cases of endometrial cancer are found in women age 55 and over. Therefore, the American Cancer Society recommends that at the time of menopause all women should be told about the risks and symptoms of endometrial cancer.
Because of their history, some women may need to consider having a yearly endometrial biopsy. Please talk with a doctor about your health history.
Women should report any unexpected vaginal bleeding or spotting to a doctor.
Other than skin cancer, prostate cancer is the most common cancer in American men. About 1 man in 9 will be diagnosed with prostate cancer during his lifetime. Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it.
The American Cancer Society recommends that men make an informed decision with a doctor 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. Men should learn about risks and possible benefits of testing and treatment before getting tested.
- Starting at age 50, men should talk to a doctor about the pros and cons of testing so they can decide if testing is right for them.
- If you are African American, you should have this talk with a doctor starting at age 45.
- If you decide to be tested, you should have the PSA blood test with or without a rectal exam. How often you are tested will depend on your PSA level.
For Men and Women
Colorectal cancer is the third most common cancer (excluding skin cancer) diagnosed in both men and women in the United States. Several lifestyle-related factors have been linked to colorectal cancer. In fact, the links between diet, weight, and exercise and colorectal cancer risk are some of the strongest for any type of cancer.
Screening should begin at age 45 for men and women of average risk.
- Highly sensitive fecal immunochemical test (FIT) every year
- Highly sensitive guaiac-based fecal occult blood test (gFOBT) every year
- Multi-targeted stool DNA test (MT-sDNA) every 3 years
- Colonoscopy every 10 years
- CT colonoscopy (virtual colonoscopy) every 5 years
- Flexible sigmoidoscopy (FSIG) every 5 years
It’s important that everyone talk to their health care provider about which tests might be good options, and to check insurance coverage for each test option.
The guidelines stress that these screening tests must be repeated at regular intervals to be effective. And, if you choose to be screened with a test other than a colonoscopy, any abnormal test result must be followed up with a timely colonoscopy to complete the screening process.
Those people at higher than average risk might need to start colorectal cancer screening before age 45, be screened more often, and/or get specific tests.