Our Guide to Cancer Screening (+ Which Ones to Get and When)

Which Cancer Screenings Do You Need?

Did you just have a birthday and now you’re wondering if there are any cancers you need to be screened for? Or maybe it’s been a few years since your last screening and you know it’s time to re-up? Or maybe you’ve heard about trendy new ways to “get a full-body scan and get everything checked in one go?”

Whatever it is, we all know there are certain cancer screenings we should get, but many of us are in the dark about which screenings we should receive and when, and which ones are not recommended as part of routine health maintenance.

Let’s take a look at the cancer screenings typically recommended for the general public, with age and frequency guidance from the U.S. Preventive Services Task Force.

Colon cancer

For the general population and in the absence of specific risk factors (like family history), you should start being screened for colon cancer at age 45 and get subsequently screened every few years (depending on results of your first screening, additional risk factors and initial screening method chosen).

Screenings may continue until 75 years of age, after which a decision with your care team may be helpful to decide if additional screening beyond that age is beneficial.

Colonoscopies remain the preferred option for screening for colon cancer. However, over the last few years, stool-based tests have become more popular and are appropriate for certain patients without risk factors, symptoms and/or previous abnormal findings on colonoscopy.

There have also been some exciting new developments in blood-based tests, though there’s still a ways to go before these are mainstream recommendations, so we’ll just have to watch and wait for the time being.

Breast cancer

Breast cancer screenings are recommended for patients born female who are at average risk beginning at age 40 and typically continue until 74. Breast cancer screening is currently recommended every one to two years using mammography.

After the age of 74, it is unclear if additional screening is beneficial, and so a discussion with your doctor can be helpful. As with all types of cancer, those with a family history of breast cancer may be recommended different screening types and at more frequent intervals.

Cervical cancer

Patients born with and who still have a cervix should receive cervical cancer screenings typically between the ages of 21 and 65. Cervical cancer is screened by a test called a pap smear, which is recommended every three to five years depending on the age of the patient.

Based on risk factors and previous pap smear results, your care team may recommend more frequent screenings and/or additional testing like a colposcopy (not to be confused with a colonoscopy). 

Lung cancer

Lung cancer screening is recommended for a specific subset of the population. Those between the ages of 50 and 80, who have a 20-pack-year smoking history, and are either current smokers or quit within the last 15 years, are eligible for lung cancer screening.

This is done with an annual low-dose lung CT scan. Given that CT scans do not eliminate all radiation exposure, these are usually only recommended for patients that meet the criteria outlined above for screening purposes. CT scans can always be done for specific conditions or symptoms but are usually not recommended for general screening purposes.

Prostate cancer

Prostate cancer screening, typically for patients who were born male (and who have a prostate), recommendations are more complicated. There are differing evidence and opinions about prostate cancer screening from various medical groups and societies.

Tests that are often associated with prostate cancer screening include a blood test called PSA and/or a digital rectal exam. It is unclear if these tests are beneficial in all cases or if they lead to additional testing (which may or may not be necessary).

So yes, this is complicated, and the best approach is one where there is a clear discussion and shared decision between you and your care team to determine whether and what type of prostate cancer screening method is right for you.

What about other types of cancer?

There are many other cancers, and some lab and imaging tests can help diagnose these cancers when there is specific suspicion, symptom or concern. However, there are no recommended routine screening tests for these other cancers (such as lymphoma, leukemia, pancreatic, thyroid, etc.).

It’s therefore very important that you communicate your risk factors and family history to your care team, and stay on top of any unusual symptoms or abnormal exam findings. This puts you in the best position to detect a potential problem early and take the right action.

Can’t I just get a full-body scan or extra blood tests?

A yearly full-body scan or a full set of blood tests may seem like straightforward ways to screen for all cancers at once. But this isn’t typically recommended for a number of reasons. Many screening procedures involve radiation, some can be invasive, and others may cause overtesting and do more harm than good, so there’s a risk that comes with an overly broad screening approach.  

Instead, your care team will work with you to identify which cancer screenings you’d benefit from, all while weighing the risks versus the benefits of specific cancer screenings. The best thing you can do to prevent cancer is stay up to date with your recommended screenings and keep your care team closely apprised on risk factors (such as family history) and new/persistent symptoms.