American Cancer Society Guidelines for the Early Detection of Cancer

Screening tests are used to find cancer before a person has any symptoms. Screening can often help find and treat pre-cancers and cancers early, before they have a chance to spread.

Here are the American Cancer Society's recommendations to help guide you when you talk to your doctor about screening for certain cancers.

• Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms (x-rays of the breast) 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, limitations, and potential harms linked to breast cancer screening. 

Women should also know how their breasts normally look and feel and report any breast changes to a health care provider right away.

Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRIs along with mammograms. (The number of women who fall into this category is very small.) Talk with a health care provider about your risk for breast cancer and the best screening plan for you.

For people at average risk for colorectal cancer, the American Cancer Society recommends starting regular screening at age 45. This can be done either with a sensitive test that looks for signs of cancer in a person’s stool (a stool-based test), or with an exam that looks at the colon and rectum (a visual exam). Talk to your health care provider about which tests might be good options for you, and to your insurance provider about your coverage. No matter which test you choose, the most important thing is to get screened.

If you’re in good health, you should continue regular screening through age 75.

For people ages 76 through 85, talk with your health care provider about whether continuing to get screened is right for you. When deciding, take into account your own preferences, overall health, and past screening history.

People over 85 should no longer get colorectal cancer screening.

If you choose to be screened with a test other than colonoscopy, any abnormal test result needs to be followed up with a colonoscopy.

Women and other individuals with a cervix at average risk for cervical cancer should start screening at age 25 and continue until at least age 65.

Test options include:

• A primary HPV test (HPV test alone) on a cervical sample collected by a health care provider every 5 years. This is the preferred option.
• A primary HPV test done on a self-collected* vaginal sample, every 3 years
• A co-test (HPV test combined with a Pap test) every 5 years
• A Pap test alone (if HPV testing isn't available) every 3 years

*Self-collection should only be done using tests and collection devices approved by the US Food and Drug Administration (FDA). These are only available through your health care provider.

Getting screened regularly is the most important thing, no matter which test you get.

You should be screened even if you’ve received the HPV vaccine or if you are in a long-term relationship with the same partner, have stopped having children, do not have sex with men, are not sexually active, or are in menopause.

You might need a different screening plan, such as being screened more often, if you’re at higher risk for cervical cancer.

You can stop screening at age 65 or older if you’ve been getting screened regularly and your last 2 HPV tests (or co-tests) or your last 3 Pap tests were normal.

People with limited life expectancy can stop screening for cervical cancer at any time.

The American Cancer Society recommends that at the time of menopause, all women should be told about the risks and symptoms of endometrial cancer. Women should report any unexpected vaginal bleeding or spotting to their doctors.

Some women – because of their history – may need to consider having a yearly endometrial biopsy. Please talk with a health care provider about your history.

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

Before deciding to be screened, people should have a discussion with a healthcare professional about the purpose of screening and how it is done, as well as the benefits, limits, and possible harms of screening. 

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.

The American Cancer Society recommends that men make an informed decision with a health care provider about whether to be tested for prostate cancer.

Starting at age 50, men should talk to a health care provider about the pros and cons of testing so they can decide if testing is the right choice for them.

If you are African American or have a father or brother who had prostate cancer before age 65, you should have this talk with a health care provider starting at age 45.

If you decide to be tested, you should get a PSA blood test with or without a rectal exam. How often you’re tested will depend on your PSA level.

• Stay away from all forms of tobacco.
• Get to and stay at a healthy weight.
• Get moving with regular physical activity.
• Eat healthy with plenty of fruits and vegetables.
• It's best not to drink alcohol. If you do drink, have no more than 1 drink per day for women or 2 per day for men.
  
• Protect your skin.
• Know yourself, your family history, and your risks.
• Get regular check-ups and cancer screening tests.