About the Guidelines

How the Guidelines Are Created

The ACS develops guidelines for cancer screening and prevention to meet the needs of clinicians, the general public, and policy. 

Screening Guidelines Development Process

Since 1980, the American Cancer Society (ACS) has introduced and periodically updated guidelines or guidance related to screening and/or informed decision-making about tests for early detection of cancers (and, in some cases, precursor lesions) of the breast, cervix, colon and rectum, endometrium, lung, and prostate. These screening guidelines have evolved with new scientific data, as new screening technologies became available, and as standards for creating guidelines changed. 

Read more about our screening guideline creation process. 

Prevention Guidelines Development Process

For people who do not use tobacco, the most important modifiable determinants of cancer risk are weight control, dietary choices, and levels of physical activity.

The American Cancer Society (ACS) publishes the Diet and Physical Activity Guideline to serve as a foundation for its communication, policy, and community strategies and, ultimately, to affect dietary and physical activity patterns among people living in the US. This guideline is developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, it reflects the most current scientific evidence related to dietary and activity patterns and cancer risk. The guideline focuses on recommendations for individual choices but also present recommendations for community action to create a supportive social and physical environment in which individuals have genuine opportunities to choose healthy behaviors. The guideline is updated every 5-7 years, as new evidence accumulates.

Highlights

These guidelines address the populations for whom testing is recommended or not recommended, the recommended tests and testing intervals, and the benefits, limitations, and harms associated with testing for early cancer detection. 

  • ACS guidelines for the early detection of cancer in average-risk adults endorse screening for breast cancer, cervical cancer, and colorectal cancer. 
  • ACS recommends informed and/or shared decision-making for adults men considering prostate cancer screening based on uncertainties and differing values about the uncertainty of the balance of benefits and harms.
  • ACS lung cancer screening guidelines also stress informed and shared decision-making. 
  • ACS guidelines for risk reduction and prevention include recommendations for nutrition and physical activity and for use of the human papillomavirus (HPV) vaccine.

Current Guidelines

Breast Cancer

The American Cancer Society recommends that women undergo regular screening mammography for the early detection of breast cancer.

Cervical Cancer

These guidelines from the American Cancer Society recommend different surveillance strategies and options based on a woman’s age, screening history, and other risk factors.

Colorectal Cancer

The American Cancer Society recommends that adults at average risk for colorectal cancer undergo regular screening starting at age 45, with either a high-sensitivity stool-based test or a structural (visual) examination.  As a part of the screening process, all positive results on non-colonoscopy screening tests should be followed up with timely colonoscopy.

Endometrial Cancer

On reaching menopause, all women should be informed about the risks and symptoms of endometrial cancer and strongly encouraged to report any unexpected bleeding or spotting to their physicians. There is no evidence, however, to support the screening of asymptomatic women and some evidence against screening. Women with or at risk for HNPCC should be offered screening annually by age 35.

Lung Cancer

The most recent version of the American Cancer Society (ACS) lung cancer screening guideline [from 2018] is being taken down while we review new scientific evidence to be included in the next update. While this important update is being completed, the ACS advises that health care providers, and people at increased risk for lung cancer, follow the recently updated recommendations for annual lung cancer screening from the US Preventive Services Task Force (USPSTF), the American Academy of Family Physicians (AAFP), or the American College of Chest Physicians. These organizations recommend yearly lung cancer screening with LDCT scans for people who:

  • Are 50 to 80 years old and in fairly good health,
    and
  • Currently smoke or have quit in the past 15 years,
    and
  • Have at least a 20 pack-year smoking history. (This is the number of packs of cigarettes per day multiplied by the number of years smoked. For example, someone who smoked 2 packs a day for 10 years [2 x 10 = 20] has 20 pack-years of smoking, as does a person who smoked 1 pack a day for 20 years [1 x 20 = 20].)

In addition, it’s important that people who are going to be screened:

  • Receive counseling to quit smoking if they currently smoke,
    and
  • Have been told by their doctor about the possible benefits, limits, and harms of screening with LDCT scans,
    and
  • Can go to a center that has experience in lung cancer screening and treatment.

Prostate Cancer

The American Cancer Society recommends that asymptomatic men who have at least a 10-year life expectancy have an opportunity to make an informed decision with their health care provider about screening for prostate cancer after they receive information about the uncertainties, risks, and potential benefits associated with prostate cancer screening. The guideline provides detailed recommendations for clinicians concerning the core factors related to prostate cancer screening and treatment that should be shared with men to enable them to make a truly informed decision regarding whether to be screened.

Nutrition and Physical Activity Guidelines

Since 1991, the American Cancer Society has published guidelines that focus on nutrition and physical activity, aimed at advising health care professionals, policy makers, and the general public about dietary and other lifestyle practices that reduce cancer risk. These guidelines provide a summary of the current scientific evidence about weight control, physical activity, and nutrition related to cancer prevention. 

In addition to recommendations regarding individual choices, the ACS guideline underscores what communities can and should do to facilitate healthy eating and physical activity behaviors.

Most recently, the 2020 Diet and Physical Activity Guidelines for Cancer Survivors provide health care providers and patients with evidence-based information to help cancer survivors and their families make informed choices related to nutrition and physical activity, to improve treatment outcomes, quality of life, and overall survival.
 

Vaccine Guidelines

The American Cancer Society recommends HPV vaccination for boys and girls between age 9 and 12. Children and young adults age 13 through 26 who have not been vaccinated, or who haven’t completed the vaccine series, should get the vaccine as soon as possible.