Cancer Screening

What is cancer screening?

Cancer screenings are tests that check for signs of cancer before you have symptoms. Screenings help healthcare providers find some cancers at an early stage, when they’re easier to treat and possibly cure. Sometimes, screenings detect precancerous changes in your body before cancer starts. When this happens, screenings lead to cancer prevention.

If you’re like most people, you’ll start getting regular cancer screenings in your 40s. You may need them sooner if you’re considered high risk for cancer. Your provider can explain what screenings you need and when you’ll need them.

When is cancer screening performed?

Your healthcare provider will perform cancer screenings based on your age and cancer risk. In the U.S., a panel of experts called the U.S. Preventive Services Task Force sets cancer screening guidelines. They study how effectively screening tests prevent diseases and their worst outcome — death — in a population. They only recommend tests after gathering evidence that they’re effective and safe.

Also, they only recommend cancer screenings when research shows that the benefits clearly outweigh the risks.

• Benefits of cancer screening include catching cancer early. Early detection is the best way to prevent cancer, cure it and help people live longer.
• Risks of cancer screening include inaccurate test results or overdiagnosis. While rare, inaccurate test results can delay care. Overdiagnosis can lead to unnecessary care that doesn’t improve your outlook.

Cancer screening guidelines vary based on whether you have factors that increase your cancer risk.

For example, risk factors include having a family history of cancer or a genetic mutation known to cause cancer. Your healthcare provider will consider your risk factors to determine what cancer screenings you need.

What cancer screening tests are recommended?

For people of average risk, the U.S. Preventive Services Task Force recommends cancer screenings for:

• Breast cancer
• Cervical cancer
• Colon cancer

Studies show that the benefits of screening for these cancers clearly outweigh potential risks. They save lives.

Breast cancer screenings

Breast cancer screenings for people of average risk should start at age 40. Current guidelines recommend having a mammogram every two years. Research shows that regular mammograms can find breast cancer early, when it’s easier to treat. They lower the rate of breast cancer-related deaths.

You may need more frequent screenings or additional tests (like a breast MRI) if your breast cancer risk is considered higher than average. Your healthcare provider may do a breast cancer risk assessment to determine your risk.

Cervical cancer screenings

Cervical cancer screenings should start at age 21. In addition to finding cancer early, cervical cancer screenings can detect precancerous cells (cervical dysplasia) that can progress to cancer. They can reveal signs of an HPV infection that may lead to cancer.

Tests used to screen for cervical cancer include:

• Pap smear: Detects cancer or precancerous cells
• HPV test: Detects high-risk strains of HPV that cause cervical cancer

Cervical cancer screening guidelines are:

• Ages 21-29: A Pap smear every three years
• Ages 30-65: A Pap smear and human papillomavirus (HPV) test every five years OR a Pap smear every three years OR an HPV test every five years

Colon cancer screenings

People of average colon cancer risk should start screenings at age 45. Colon cancer is the third leading cause of death in the U.S. But screenings can detect colon cancer when it’s still curable. Screening tests can find noncancerous polyps with the potential to become cancerous so that providers can remove them. In this way, screenings prevent colon cancer.

Colon cancer screenings usually involve getting a colonoscopy every 10 years. Other screening methods are:

• Fecal occult blood tests every one to three years (the timeline depends on the specific test: FIT, gFBOB or stool DNA test)
• Virtual colonoscopy every five years
• Flexible sigmoidoscopy every five years
• Flexible sigmoidoscopy every 10 years plus annual FIT (a type of fecal occult blood test)

What are other common cancer screening tests?

There are other cancer screening tests available that you may want to discuss with your provider. In certain cases, a test may benefit some people but not everyone. Or there may not be enough evidence yet that the benefits of the tests outweigh potential risks.

Other cancer screening tests include:

• Lung cancer screening. An imaging procedure checks for signs of lung cancer. Your provider may recommend it if you’re between 50 and 80 and have a smoking history.
• Oral cancer screening. A provider looks for signs of cancer in your mouth. Although there are no official screening recommendations, your dentist may do this as part of a routine checkup.
• Prostate cancer screening. A PSA blood test finds signs of prostate cancer. Your healthcare provider may recommend getting it if you’re between ages 55 and 69.
• Skin cancer screening. A dermatologist checks your skin for signs of cancer. Evidence is lacking when it comes to proving that screenings reduce skin cancer-related deaths. Still, many people get annual full-body skin cancer screenings.

How do cancer screenings work?

Before your screening, a healthcare provider will tell you what to expect during the test. This includes instructions about how you should prepare. They’ll explain what the results will and won’t be able to reveal about your health.

Cancer screenings involve different types of tests, including:

• Physical examination. A healthcare provider may check your body for any changes, like unusual lumps. They’ll ask questions about your health habits and your family’s health history.
• Imaging tests. These tests obtain images of areas inside your body. Mammograms and colonoscopies are examples of imaging tests that screen for cancer.
• Lab tests. These tests may include blood tests for cancer and tests to obtain tissue. Pap smears are an example of a screening test providers use to collect tissue so medical pathologists can check for signs of cancer.
• Genetic tests. The tests check your DNA to see if you have a change (mutation) that increases your cancer risk.

Multiple cancer detection (MCD) tests

The Galleri test is a new blood test that can detect more than 50 types of cancer. The U.S. Food and Drug Administration (FDA) hasn’t approved this test for regular use. Talk to a healthcare provider if you’re interested in learning about this test.

What does a cancer screening test result mean?

Cancer screening tests look for changes in your body that could be a sign of cancer. The test result isn’t a cancer diagnosis or a sign that you’re cancer-free. Sometimes, cancer screening tests show unusual results. In that case, your healthcare provider may recommend more tests. Just like initial screening tests, simply having an additional test doesn’t mean you have cancer.

When should I know the results of my test?

Some test results are available within a few days. Other times, it may be a week or so before your healthcare provider receives your results and can share them with you. Ask your provider about when you’ll receive results.

What happens if my screening test shows signs of cancer?

It’s important to remember that a screening test isn’t diagnostic. If your results show signs of cancer, your healthcare provider may do more tests to get more details about what’s happening. Likewise, a screening test that doesn’t find signs of cancer isn’t a clean bill of health. Cancer starts small and may grow very slowly. Ask your healthcare provider when you’ll need another screening test.

What questions should I ask my healthcare provider?

Contact your healthcare provider if you’re unsure about what screenings you need. This is especially the case if you’re high risk or if you’ve had previous procedures that may impact your cancer prevention plan. For example, if you’ve had surgery to remove a reproductive organ, you may need cancer screenings that align with your sex recorded at birth. If you’ve had surgery to remove your uterus (hysterectomy), you may or may not have a cervix that requires cervical cancer screenings. It depends on the specific procedure.

Questions you may want to ask include:

• What cancer screening tests do you recommend for me?
• Why do you recommend those tests?
• Do I need these tests right away?
• Can you do those tests or should I see a specialist?
• Are there screening tests that I can do at home?
• How often should I get the screening tests?