Routine Cancer Screenings

Cancer screening is a way to check for cancer before you have any symptoms. The goal is to find cancer early when it is most treatable — before it has a chance to grow or spread. Regular screenings for breast, colorectal, prostate, skin, lung, and cervical cancer are usually recommended by doctors based on your age and other risk factors.

Breast Cancer

Most people who get breast cancer are women (but men can get breast cancer — see below). That is why screening is often recommended for women starting at age 40. If you are between 40 and 74 years old, it is recommended to get a breast cancer screening every two years.

This recommendation is for people at an average risk of developing breast cancer. Some known risk factors that can increase the risk of developing breast cancer include:

• Having a family history of cancer
• Having the BRCA gene variant or other genetic variations
• Having a personal history of a previous breast cancer
• Being older in age
• Having dense breast tissue
• Race and ethnicity (Black women are more likely to get aggressive forms of breast cancer and more likely to die from breast cancer than White women)

Mammography is the most effective method to screen for breast cancer. A mammogram is a breast x-ray. This test can capture a 2- or 3-dimensional (2D or 3D) image of the breast. There are two types of mammograms:

1. A mammogram uses an x-ray to take pictures of the inside of the breast. These pictures can help see early signs of breast cancer, even before feeling a lump or symptoms appear. Your doctor may order a diagnostic mammogram as a follow-up to your screening mammogram.
2. A diagnostic mammogram provides a more detailed image of any suspicious lumps or concerns.

Women at a higher risk of developing breast cancer may require screening with a breast magnetic resonance imaging (MRI) or ultrasound, in addition to their mammogram. How often you do these may be different than if you are considered average risk. Your primary care doctor or gynecologist may also do a clinical breast exam during your annual visit. A clinical breast exam is when your doctor examines and gently feels your breasts for any suspicious lumps or changes in how they look.

People of all genders have breast tissue, and therefore can get breast cancer, including men, transgender, and non-binary individuals. Breast cancer is most common in people assigned female at birth. If you have breast tissue, you may be at risk.

Men make up nearly 1% of all breast cancer diagnoses. Some known risk factors that can increase the risk of men developing breast cancer include:

• Having a family history of cancer
• Having the BRCA gene changes or other genetic changes
• Elevated estrogen levels
• Obesity

Breast cancer is often found at a later stage in men. There is a lack of education and awareness about breast cancer in men. It is important to know the warning signs of male breast cancer. Currently, there are no general screening guidelines for breast cancer in men.

It is normal to feel uncomfortable or embarrassed to discuss concerns about breast tissue with your doctor. It is important to seek help as soon as you notice any changes.

Colorectal Cancer

It is now recommended that adults between 45−75 years old are screened for colorectal cancer. Colorectal cancer rates are increasing in young adults under age 50. Because of this, screening guidelines now recommend starting at age 45, even if you feel healthy and have no symptoms.

There are both lifestyle and inherited (genetic) factors that can increase your risk of developing colorectal cancer. Lifestyle factors are daily habits or behaviors that increase your risk of developing cancer. Inherited factors are passed down by your parents, and they cannot be changed.

Some risk factors for colorectal cancer include:

• Age – Risk goes up as you get older.
• Heredity – Inherited genetic conditions and family history of colorectal and certain other cancers can increase risk.
• Unhealthy behaviors – Eating a lot of red or processed meat, little to no exercise, smoking, and excessive alcohol use increase risk.
• Chronic conditions – Conditions like type 2 diabetes and inflammatory bowel disease increase risk.

Speak with your doctor about when you should be screened for colorectal cancer.

There are several screening tests to detect early signs of colorectal cancer. Each method has its own benefits and risks. It is important to consider your lifestyle and personal preferences when deciding which method is right for you. Discuss your screening options and questions with your doctor to decide on the best approach.

Stool-based Tests

Stool-based tests will check your stool (poop) for signs of hidden blood and abnormal DNA. Precancerous growths can cause small amounts of blood in your stool. Finding blood or genetic changes in your stool may be a sign of colorectal cancer.

Stool-based testing is less invasive and often requires less preparation than direct visualization testing. These tests can be done in the privacy of your own home, using a kit that helps you collect a stool sample. It is normal to feel unsure about collecting your own stool sample. If doing this every year does not feel right, find the screening test that is right for you.

Stool-based tests include:

• Guaiac Fecal Occult Blood Test (FOBT) - Every 1 year
• Fecal Immunochemical Test (FIT) - Every 1 year
• Stool DNA Test - Every 1-3 year

Prostate Cancer

All people assigned male at birth have prostate tissue and are therefore at risk for prostate cancer. People with prostates between the ages of 55–69 should talk with their doctor about their prostate cancer screening options. For people with a family history and increased risk, screening for prostate cancer is appropriate and needed.

The prostate-specific antigen (PSA) test is the most widely accepted screening method. A PSA test is a simple blood test. Your doctor takes a small sample of your blood to measure the level of PSA, a protein made by the prostate. Elevated PSA levels may not always indicate prostate cancer; it can also be related to other conditions that are not cancer.

A digital rectal exam (DRE) is another way to check for signs of cancer. During a DRE, the doctor uses a lubricated, gloved finger inserted into the rectum to feel the prostate. However, current guidelines suggest that DRE is no longer the recommended screening method, as research has shown that this screening method is not the best way to detect prostate cancer at an early stage.

The decision to be screened is personal and dependent on your risk of developing prostate cancer. Most early prostate cancer is completely without symptoms, which is why PSA screening is important. While the following symptoms can be related to a variety of non-cancer issues, some early symptoms of prostate cancer may be:

• Weak or interrupted urine flow
• Blood in urine or semen
• Pain or burning during urination
• Frequent urination, especially at night
• Erectile dysfunction

Contact your doctor right away if you notice any unusual urinary symptoms. Take action — ask about whether prostate cancer screening is right for you.

Lung Cancer

Yearly lung cancer screenings are recommended for adults aged 50−80 with a 20-pack year smoking history. A pack year measures how much a person has smoked throughout their life. A pack year is the number of packs per day smoked multiplied by the number of years you smoked. You may still be eligible for screening if you currently smoke or have quit within the past 15 years.

Low-dose CT (LDCT) scans of the chest are the widely accepted screening test for lung cancer. This quick, noninvasive scan looks for early signs of lung cancer. LDCT scans capture detailed images of your lungs. During your scan, you will lie flat on a table while a series of x-ray images are taken. An LDCT uses significantly less radiation than the normal CT scan. However, as with all x-rays, there is still the risk of radiation exposure.

Some risk factors for lung cancer are lifestyle factors that can be changed. There are some you cannot change. These are common risk factors for the disease:

• History of smoking
• Exposure to secondhand smoke
• Age
• Environmental exposures
• Family history

Keep in mind that anyone can get lung cancer. Lung cancer happens when the cells in the lung change. People who have a history of smoking may experience feelings of stigma, guilt, or shame, but several factors can cause this change. Speak with your doctor about your concerns and how you can focus on things within your control. Talk to your doctor if you feel that you have an increased risk of lung cancer and are not eligible for screening under current guidelines.

Cervical Cancer

Everyone with a cervix should begin screening for cervical cancer at 21 years old. Most people assigned female at birth have cervical tissue and are therefore at risk for cervical cancer. The type of screening method and how often it is done may vary. Your doctor will consider your age and other factors to determine the best screening method for you.

A Pap test, also known as a Pap smear, is a screening procedure that looks for cancerous cells in your cervix. Your healthcare provider will collect a sample of cells from your cervix and look at them under the microscope.

Cervical cancer is not generally thought to be inherited. This cancer is highly associated with infection from certain types of a virus called the human papilloma virus (HPV). This type of virus is very common. It is passed through sexual activity. Most often, HPV does not cause any symptoms. Only certain high-risk types of HPV increase cervical cancer risk. Getting the recommended HPV vaccine can reduce the risk of cervical cancer.

Research is improving our understanding of cervical cancer and its causes. The following are known risk factors for the disease:

• HPV infection
• Long-term use of birth control pills
• Smoking
• Chlamydia infection
• Multiple pregnancies/early pregnancy

Currently, individuals between 21–29 years old should be screened for cervical cancer using a Pap test every three years.

If you are between the ages of 30–65 years, the different screening options for cervical cancer include:

• Pap test: Screen every 3 years using only the Pap test.
• HPV testing: Screen every 5 years using only HPV testing.
• Co-testing: Screen every 5 years with the Pap test and HPV testing at the same time.

If you are unsure which screening option is right for you, reach out to your doctor. Ask your doctor to explain the risks and benefits of each option to choose a method that works best for you.

When caught early, many cancers are easier to treat. Here are some steps you can take to detect cancer early. Following these steps can help you be more aware and catch any early signs and symptoms of cancer. Talk to your doctor right away if you notice any unusual changes when performing your self-exam.

Monthly Skin Self-exams

Check all the surfaces of your skin and look closely at your moles so that you can tell if they begin to change shape, size, or color. Bleeding or itching can also be a sign of skin cancer.

Use the ABCDEs of melanoma skin cancer to help guide your self-exams.

• Asymmetry – The shape of one half does not match the other.
• Border – The edges are often ragged, notched, blurred, or irregular in outline; the pigment may spread into the surrounding skin.
• Color – The color is uneven. Shades of black, brown, and tan may be present. Areas of white, grey, red, pink, or blue may also be seen.
• Diameter – There is a change in size, usually an increase.
• Evolving – Changes in size, shape, color, or elevation (how raised it is), or any symptoms such bleeding, itching, or crusting.

Skin cancer is one of the most common types of cancer in the world. But it is easier to treat and cure when it is found early. Consider completing a skin check appointment with your doctor or a dermatologist to assess your skin for any concerning spots or moles.

Monthly Testicular Self-exams

Check the testicles for new lumps or swelling. If you are familiar with your testicles, it is easier to notice any unusual changes at an early stage.

Most men find their own testicular cancers first. Between regular checkups, men should look out for symptoms like:

• A dull ache in the lower abdomen, back, or groin
• If a testicle gets larger or feels different
• A heavy feeling in the scrotum
• Pain or aches in a testicle or the scrotum
• A lump or swelling in a testicle, with no pain
• Fluid in the scrotum

Monthly Breast Self-exams

Check the breasts for any unusual changes. This exam should be performed while standing in the mirror or lying down. Regular breast self-exams help you become familiar with the way your breasts typically look and feel. This makes it easier to identify any lumps or skin changes.

Breast self-exams should be done a few days after your menstrual cycle ends. If you do not have an active menstrual cycle, you should perform your self-exam on the same day each month. Make sure to pick a date that you will easily remember, such as the first or last day of the month.

The benefits of early detection through routine screening are well known. Yet, many people are behind on their routine screenings. This may be due to challenges or concerns around screening. It is normal to have concerns that may stop you from scheduling a routine screening exam. There also may be misunderstandings or misconceptions about screening.

Here is a list of common screening concerns and tips to overcome them:

Financial

The cost of medical services or not having health insurance can be a barrier to getting routine screenings. A financial navigator or social worker can help address your concerns around screening costs. They can help you understand your insurance coverage. You can also call your insurance provider directly and ask questions about screening costs.

Financial navigators assist people with financial issues related to cancer, including providing referrals to resources that may help with cancer-related treatment expenses. Services also include tips on how to manage treatment-related costs, how to communicate with healthcare providers about the cost of care and payment, and understanding insurance benefits.

Educational

There are many ways to detect cancer early. It can be overwhelming trying to remember all the screening recommendations. The first step is to learn which routine screening tests you are eligible for based on your age and risk factors. Schedule your routine exams and speak with your doctor regularly about how your screening plans may change over time

Emotional

Fear is a very common reason that prevents people from scheduling their routine screening exams. Screening for cancer can feel like a scary process. It is normal to feel anxious before a screening procedure and while waiting for the results. If you are feeling anxious about any part of the cancer screening process, reach out to your doctor to discuss your concerns. Completing the recommended screenings on time is important for early detection. Early detection gives you more treatment options and can make cancer easier to manage.

Note: You might feel nervous while waiting for test results, worried about a loved one’s upcoming scan, or tense as your next follow‑up appointment gets closer. For many people, managing your emotions becomes one of the hardest parts of life during and after cancer.

If you notice yourself feeling anxious as a scan or appointment approaches, you are not alone. This type of worry is so common in the cancer community that it even has a name: “scanxiety.”

Cultural

Despite potentially higher cancer rates, certain racial and ethnic groups and underserved communities tend to screen less often. Individuals in these communities may feel anxious or hesitant to screen for cancer because of:

• Language barriers
• Medical mistrust
• Personal and cultural beliefs and values
• Geographic location

It is important to find a care team that listens to and respects your wishes and values. Talk with your doctor about your personal risk and work with them to create a screening schedule that is best for you.