Annual cancer screenings: Which ones do you need and when?
Cancer screenings are essential elements of preventive care. They allow for early detection of cancer and for treating cancer as soon as possible. Screenings don't exist for every type of cancer, but screenings for the most common types — breast, lung, colorectal, cervical, and skin cancers — help minimize your risk for the disease.
So which cancer screenings do you need? That depends on your sex, age, and risk factors. Below is a breakdown of the screenings you will most likely need and when to schedule them.
Breast cancer screening
The American Cancer Society recommends women at average risk begin annual mammograms at age 45, but they should have the option to begin screening at age 40. In addition, most private insurers cover annual screening mammograms for women at that age. Women ages 55 and older may continue with a yearly screening or switch to screening every other year.
Women at high risk for breast cancer may need to begin screenings before age 40. You're considered at high risk if you have:
- Dense breast tissue (more fibrous and glandular tissue than fatty tissue)
- A family history of breast cancer
- Genetic mutations, particularly in the breast cancer 1 (BRCA1) and breast cancer 2 (BRCA2) genes
- Had radiation treatments before age 30
Reid Health offers advanced 3D mammograms, which offer greater detail and improve cancer detection in women younger than age 50 and those with dense breasts. If your mammogram reveals a lump or other abnormality, additional imaging with an ultrasound or MRI might be necessary to investigate further.
Clinical and breast self-exams are no longer recommended as screenings for breast cancer, but they can help identify changes in your breasts. Performing a monthly breast self-exam helps you familiarize yourself with how your breasts normally look and feel so you can discuss changes or concerns with your OB/GYN.
Cervical cancer screening
Screening for cervical cancer should begin at age 25 and continue until you reach age 65 and have received routine screenings for at least 10 years with good results. Women who had significant cervical pre-cancer dysplasia should continue screening for 25 years after the diagnosis, even after turning 65.
Between ages 25 and 65, you should have a primary human papillomavirus (HPV) test or a co-test, which includes an HPV and Pap test, every five years. Another alternative is to have a Pap test alone every three years.
You should proceed with the screening recommendations in your age group, even if you have received the HPV vaccine. If your cervix was surgically removed for reasons other than cancer, you don't need screening.
Colorectal cancer screening
Adults at average risk for colorectal cancer should start routine screening at age 45 and continue through 75. Between ages 76 and 85, you should discuss whether you need screening with your provider. Most adults no longer need colorectal cancer screening after age 85. The frequency and type of screening you need depend heavily on your risk factors for the disease.
- Colonoscopies are considered the gold standard for colorectal cancer screening because they allow doctors to find and remove the precancerous polyps where colorectal cancer begins. These screenings need to be performed only once every 10 years.
Lung cancer screening
Low-dose CT screening is the only recommended screening for lung cancer. The CT scan uses minimal radiation to take highly detailed images of the lungs to reveal the disease early, when it's most treatable. Low-dose CT screening is helping people with lung cancer live longer than ever before because it's able to detect cancer earlier.
Lung cancer screenings have very specific criteria. You may need one if you:
- Are ages 50 to 80 AND
- Have a 20 pack-year smoking history AND
- Currently smoke or quit within the past 15 years
Twenty pack-years equates to smoking a pack of cigarettes per day for 20 years, two packs a day for 10 years, and so on. If you quit smoking 15 or more years ago or have a health concern that makes lung surgery difficult, you may not qualify for screening.
For those with Medicare Part B, annual lung cancer screenings are covered if you're between ages 50 and 77, have no symptoms, receive an order from your clinician, and meet the guidelines mentioned above.
Prostate cancer screening
Although prostate cancer screenings can detect the disease early, they can also detect cancers that may not need treatment. For that reason, there is no standard screening guideline for this disease. Instead, men should talk to their doctors to determine if testing is necessary for them and, if it is, when and which screenings are necessary. The American Cancer Society recommends those discussions begin:
- At age 50 for men at average risk who are expected to live 10 years or longer
- At age 45 for men at high risk (Black men and those with a close relative who had prostate cancer before age 65)
- At age 40 for men with an even higher risk, defined as having more than one close relative who had prostate cancer before age 65
If your doctor determines you need prostate cancer screening, you should get the prostate-specific antigen (PSA) blood test, which measures levels of PSA, a protein in the blood that can indicate prostate cancer. If cancer is detected, providers may choose to keep a close eye on the situation, also called watchful waiting, because prostate cancer often grows very slowly.
Skin cancer screening
Skin cancer is the most common cancer in the United States, but there's no agreed-upon guideline for routine screening. People with skin cancer risk factors — blonde or red hair, blue or green eyes, lighter skin tone, skin that burns or freckles easily, and a family or personal history of skin cancer — should check with their provider about how often they should be screened.
You can also identify potential skin cancers early with regular skin self-exams. Look for moles unusual in size, shape, or color. These blemishes may change in appearance, as well.
Your primary care provider can help you stay on
schedule with the cancer screenings you need. Find a primary care provider
close to where you live or work.