American Cancer Society Screening Guidelines Summary

For all women:

• Talk with your doctor about your risk for breast cancer.
• Know how your breasts normally look and feel. Report any breast changes to a health care provider right away.
• Be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening.
• Your personal and family history might affect your recommended screening plan.

For women at average risk:

• Women ages 40 to 44 should have the choice to start annual breast cancer screening with a mammogram.
• Women age 45 to 54 should get a mammogram every year.
• Women 55 and older can switch to a mammogram every 2 years, or continue getting a yearly mammogram.

For women at high risk:

• Women at high risk based on personal or family history or other risk factors should be screened regularly with a breast MRI along with a mammogram, typically starting at age 30.

For all women and people with a cervix:

• Talk with your doctor about your risk for cervical cancer.
• Start regular screening at age 25.
• Follow testing recommendations even if you've been vaccinated against HPV.
• Your personal, family, surgical, and vaccination history might affect your recommended screening plan.

If your cervix was removed for a reason other than cervical cancer or pre-cancer, you don’t need further cervical screening tests.

For people at average risk:

• People between the ages of 25 and 65 should get a primary HPV (human papillomavirus) test done every 5 years.
• If a primary HPV test is not available, a co-test (an HPV test with a Pap test) can be done every 5 years. Or a Pap test can be done every 3 years.

For people at high risk:

• People at high risk based on personal or family history or other risk factors may need to be screened more often.
• People with a history of a serious cervical pre-cancer should continue testing for 25 years after that diagnosis.

For all men and women:

• Talk with your doctor about your risk for colon and rectal (colorectal) cancer.
• Your personal and family history might affect your recommended screening plan.

For people at average risk:

• Regular screening should start at age 45. If you’re in good health, you should continue regular screening through age 75.
• Screening test options include a stool-based (fecal) test that can be done at home every 1-3 years, depending on the type of test. Other test options include a visual exam (colonoscopy, sigmoidoscopy, CT colonography) that requires a bowel prep and looks at the colon and rectum.
• If you choose to be screened with a test other than colonoscopy, any abnormal test result needs to be followed up with a timely colonoscopy.

For people at high risk:

• ACS does not have screening guidelines specifically for people at high risk of colorectal cancer. People at high risk based on personal or family history or other risk factors might need to start colorectal cancer screening earlier, be screened more often, and/or get specific tests.

For all women:

• All women should talk with their doctor about their risk for endometrial cancer.
• Your personal and family history might affect what’s recommended for you.
• Some women are at high risk due to age, late menopause, never giving birth, infertility, obesity, diabetes, high blood pressure, estrogen treatment or tamoxifen therapy.
• It’s important to know that tests used to screen for cervical cancer are not effective for endometrial cancer.

For women at average risk:

• There are currently no screening tests to find endometrial cancer early in women at average risk who have no symptoms.
• At the time of menopause, women at average risk should be told by their doctor about the risks and symptoms of endometrial cancer. They should also be strongly encouraged to report any vaginal bleeding, discharge, or spotting.

For women at high risk:

• Women at high risk should be informed of their risk and see their doctor if and whenever they have any abnormal vaginal bleeding.
• Women with HNPCC (hereditary non-polyposis colon cancer or Lynch syndrome) have a very high risk of endometrial cancer and should be offered yearly testing with an endometrial biopsy starting at age 35.

For all men and women:

• All men and women should talk with their doctor about their risk for lung cancer.
• If you smoke or used to smoke, you might have a high risk for lung cancer. It’s important to know your pack-year history. A pack-year is equal to smoking 1 pack (or about 20 cigarettes) per day for a year.
• Regular screening is recommended for certain people at high risk for lung cancer who are in good health.

For people at high risk:

• Before deciding to be screened, talk with your doctor about the purpose of screening and how it is done, as well as the benefits, limits, and possible harms of screening.
• Yearly screening with a low-dose CT (LDCT) scan is recommended for people in good health who are ages 50 to 80, who smoke or used to smoke, and have at least a 20 pack-year history of smoking.
• People who still smoke should be counseled about quitting and offered resources to help them.

For all men:

• All men should talk with their doctor about their risk for prostate cancer.
• All men should make an informed decision with their doctor about whether to be screened after getting information about the possible benefits, risks, and uncertainties of prostate cancer screening.
• Your personal and family history might affect your decision to be screened.

For men at average risk:

• The discussion about screening should take place at age 50 for men who are expected to live at least 10 more years.
• Men who want to be screened should get the prostate-specific antigen (PSA) blood test. Future screening depends on the results of the PSA blood test.

For men at high risk:

• The discussion about screening should take place at age 45 for African American men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer before age 65.
• The discussion about screening should take place at age 40 for men at even higher risk who have more than one first-degree relative who had prostate cancer before age 65.
• Men who want to be screened should get the prostate-specific antigen (PSA) blood test. Future screening depends on the results of the PSA blood test.