Inside NCI: A Conversation with Dr. Barry Kramer about Cancer Screening.
Some types of cancer can be found before they cause symptoms. Checking for cancer (or for conditions that may lead to cancer) in people who have no symptoms is called screening. Screening can help doctors find and treat some types of cancer early. Generally, cancer treatment is more effective when the disease is found early. However, not all types of cancer have screening tests. Genetic testing can also offer risk assessment. See bottom of this page for details.
Get more info at the National Cancer Institute.
The American Cancer Society recommends these screening guidelines for most adults.
- Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health
- Clinical breast exam (CBE) about every 2 years for women in their 20s and 30s and every year for women 40 and over
- Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.
- Click HERE to learn how to do a breast self-exam.
The American Cancer Society recommends that some women -- because of their family history, a genetic tendency, or certain other factors -- be screened with MRI in addition to mammograms. (The number of women who fall into this category is small: less than 2% of all the women in the US.) Talk with your doctor about your history and whether you should have additional tests at an earlier age. For more information, visit the American Cancer Society website and read Breast Cancer: Early Detection.
Colorectal cancer and polyps
"The American Cancer Society recommends that people at average risk* of colorectal cancer start regular screening at age 45.
This can be done either with a sensitive test that looks for signs of cancer in a person’s stool (a stool-based test), or with an exam that looks at the colon and rectum (a visual exam). These options are listed below. People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75. For people ages 76 through 85, the decision to be screened should be based on a person’s preferences, life expectancy, overall health, and prior screening history. People over 85 should no longer get colorectal cancer screening.
*For screening, people are considered to be at average risk if they do not have:
- A personal history of colorectal cancer or certain types of polyps
- A family history of colorectal cancer
- A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
- A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
- A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer"
Tests that check for polyps and cancer
- Colonoscopy every 10 years
- CT colonography (virtual colonoscopy) every 5 years
- Flexible sigmoidoscopy (FSIG) every 5 years
Tests that primarily check for cancer
- Highly sensitive fecal immunochemical test (FIT) every year
- Highly sensitive guaiac-based fecal occult blood test (gFOBT) every year
- Multi-targeted stool DNA test (mt-sDNA) every 3 years
* If the test is positive, a colonoscopy should be done.
** The multiple stool take-home test should be used. One test done by the doctor in the office is not adequate for testing. A colonoscopy should be done if the test is positive.
The tests that are designed to find both early cancer and polyps are preferred if these tests are available to you and you are willing to have one of these more invasive tests. Talk to your doctor about which test is best for you.
The American Cancer Society recommends that some people be screened using a different schedule because of their personal history or family history. Talk with your doctor about your history and what colorectal cancer screening schedule is best for you. For more information on colorectal cancer screening, please visit the American Cancer Society and read the article Colorectal Cancer: Early Detection.
Cervical cancer screening is an important part of women’s health care. You should start having screening at age 21, regardless of when you first start having sex. How often you should have cervical cancer screening and which tests you should have depend on your age and health history:
- Women who are 21 to 29 should have a Pap test alone every 3 years. HPV testing alone can be considered for women who are 25 to 29, but Pap tests are preferred.
- Women who are 30 to 65 have three options for testing. They can have a Pap test and an HPV test (co-testing) every 5 years. They can have a Pap test alone every 3 years. Or they can have HPV testing alone every 5 years.
- Women can stop having cervical cancer screening after age 65 if:
- they do not have a history of moderate or severe abnormal cervical cells or cervical cancer AND
- they have had either three negative Pap test results in a row, two negative HPV tests in a row, or two negative co-test results in a row within the past 10 years. The most recent test should have been performed within the past 3 or 5 years, depending on the type of test.
- Women who have had a hysterectomy may still need to have screening. The decision is based on whether the cervix was removed, why the hysterectomy was needed, and whether there is a history of severe cervical cell changes or cervical cancer. Even if the cervix is removed at the time of hysterectomy, cervical cells can still be present at the top of the vagina. If you have a history of cervical cancer or high-grade cervical cell changes, you should continue to have screening for 20 years after the time of your surgery.
Some women – because of their history – may need to have a different screening schedule for cervical cancer.
Endometrial (uterine) cancer
The American Cancer Society recommends that at the time of menopause, all women should be informed about the risks and symptoms of endometrial cancer. Women should report any unexpected bleeding or spotting to their doctors.
Some women -- because of their history -- may need to consider having a yearly endometrial biopsy. Please talk with your doctor about your history.
For people aged 20 or older having periodic health exams, a cancer-related check-up should include health counseling and, depending on a person’s age and gender, exams for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries, as well as for some non-malignant (non-cancerous) diseases.
Source: American Cancer Society
Take control of your health and reduce your cancer risk.
- Stay away from tobacco.
- Stay at a healthy weight.
- Get moving with regular physical activity.
- Eat healthy with plenty of fruits and vegetables.
- Limit how much alcohol you drink (if you drink at all).
- Protect your skin.
- Know yourself, your family history, and your risks.
- Have regular check-ups and cancer screening tests.
- Complete a hereditary screening form HERE and discuss it with your provider. (See more information below.)
Genetic Testing for Cancer Risk
Genetic screening for colon cancer:
About Cologuard®: Cologuard is a noninvasive colon cancer screening test for people 45 years of age and older who are at average risk for colon cancer. Rx only.
About getting screened for colon cancer: The Importance of Colon Cancer Screening | Cologuard® Patient Site
How To Get Cologuard® | Cologuard Patient Site This test is by prescription only. Talk with you provider or call our office if you wish to have this screening completed.
Genetic screening for breast cancer and other hereditary cancers:
Myriad’s Genetic Testing website – https://myriad.com/myrisk/
Real patient story about Breast Cancer – Ashley Dedmon - https://www.youtube.com/watch?v=lLLu2iQ12HA
Benefits of genetic testing: https://myriad.com/patients-families/genetic-testing-101/benefits-of-genetic-testing/
Hereditary Cancer resources: https://myriad.com/patients-families/hereditary-cancer-risk/
3 minute short video clip explaining hereditary cancer & myRisk https://myriad.com/myrisk/patient-education/
- How much will this cost?
- Why does a doctor need to order this for me?
- What are the potential outcomes of the test and their impact on me?
- Can the MyRisk test determine if I have cancer?
- When will I receive my results?