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What Cancer Screenings Should I Be Aware Of?

The American Cancer Society has screening guidelines for several types of cancer.  To reduce cancer disparities, we focus on prevention and early detection of breast, cervical and colorectal cancers (insert LINKS for each cancer to appropriate guideline pages on cancer.org).  Below are our recommended screening guidelines:

Breast Screening Guidelines:

The American Cancer Society recommends the following guidelines for finding breast cancer early in women without symptoms:

- Mammogram: Women age 40 and older should have a screening mammogram every year and should keep on doing so for as long as they are in good health.
- Clinical breast exam (CBE): Women in their 20s and 30s should have a clinical breast exam as part of a regular exam by a health expert at least every three years. After age 40, women should have a breast exam by a health expert every year. You can use the exam to learn what your own breasts look and feel like.
- Breast self-exam (BSE): BSE is an option for women starting in their 20s. Women should be made aware of the benefits and limitations of BSE. Women should report any changes in how their breasts look or feel to a health provider right away.

Cervical Screening Guidelines:

The American Cancer Society recommends the following:

- All women should begin having the Pap test about three years after they start having sex (vaginal intercourse), but no later than age 21.
- The test should be done every year if the regular Pap test is used, or every two years if the liquid-based Pap test is used.
- Beginning at age 30, many women who have had three normal test results in a row may get the Pap test every two to three years. Another option for women over 30 is to have a Pap test every three years plus the HPV DNA test. (See below for more information about this test.)
- Women who have certain risk factors (like HIV infection or weak immune systems) should get a Pap test every year.
- Women 70 years of age or older who have had three or more normal Pap tests in a row (and no abnormal tests in the last 10 years) may choose to stop having the test. But women who have had cervical cancer or who have other risk factors (as mentioned in “What causes cancer of the cervix?” ) should keep on having the test as long as they are in good health.
- Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having the test unless the surgery was done as a treatment for cervical cancer or pre-cancer. Women who have had a simple hysterectomy (the cervix was not removed) should continue to follow the guidelines above.

Some women believe that they can stop having Pap tests once they have stopped having children. This is not correct. They should continue to follow American Cancer Society guidelines.

Colorectal Screening Guidelines:

The American Cancer Society believes that preventing colorectal cancer (and not just finding it early) should be a major reason for getting tested. Finding and removing polyps keeps some people from getting colorectal cancer. Tests that have the best chance of finding both polyps and cancer are preferred if these tests are available to you and you are willing to have them.

- Beginning at age 50, both men and women at average risk for developing colorectal cancer should use one of the screening tests below:

Tests that find polyps and cancer

- Flexible sigmoidoscopy every five years*
- Colonoscopy every 10 years
- Double-contrast barium enema every five years*
- CT colonography (virtual colonoscopy) every five years*

Tests that mainly find cancer

- Fecal occult blood test (FOBT) every year*,**
- Fecal immunochemical test (FIT) every year*,**
- Stool DNA test (sDNA), interval uncertain*

*Colonoscopy should be done if test results are positive.
**For FOBT or FIT used as a screening test, the take-home multiple sample method should be used. An FOBT or FIT done during a digital rectal exam in the doctor's office is not adequate for screening.

What Help is There to Pay for Screening?

Each state administers the National Breast and Cervical Cancer Program which provides free mammograms and pap tests to income-qualified women.

Local clinics and hospitals may also offer some colorectal tests for cancer.  Please call 1-800-227-2345 24 hours a day, 365 days a year to get a referral to an assistance program in your area.