Cancer Screenings: Which You Might Need

Cancer, in all its forms, can too often take people entirely by surprise. When it does, the disease can be in its late stages by the time people receive a diagnosis, and by that time, treatment options are more limited. One of the best ways to catch cancer early and in its most treatable stages is cancer screenings.

Screenings are performed before a patient has any identifiable symptoms. They help detect any small irregularities or problems that are cancerous, or sometimes even precancerous, and have proven to be effective at reducing the number of deaths from some types of cancer.

There are many types of screenings available, and which you should consider can vary by age, gender, and personal risk factors. Below is a breakdown of the most recommended screenings for everyone and essential screenings for both men and women specifically.

Screenings for Everyone

Some cancer screenings are recommended for both men and women, specifically tests or procedures designed to detect early signs of colon or lung cancer.

Colon Cancer

Some people should be screened regularly for colon cancer starting at or between the ages of 45 and 50, including those who do not have a personal or family history of colorectal cancer or cancer syndrome, certain types of polyps, any sort of inflammatory bowel disease, or a personal history of receiving abdominal or pelvic radiation to treat other cancers.

If you fall into any of those categories, you may be at an increased or higher risk for colon cancer and may need to begin screening before the recommended age, have specific types of screenings done, or be screened more often. Your medical provider can help you determine what may be best for you.

Screenings should be done for people in good health through the age of 75 at intervals determined by the kind of procedure performed. People aged 75-85 may be screened depending on personal risk factors. After 85, people generally don’t need to continue the procedure.

Your healthcare provider can tell you which type of screening test would be most appropriate for you to get. The most commonly performed colon cancer screenings generally fall into one of two categories: visual or structural exams of the colon and rectum (e.g. colonoscopy), and stool-based tests.

Visual or Structural Exams

A colonoscopy is the most common visual exam performed and should be done once every ten years. A camera is inserted into the rectum and colon (large intestine) to allow a healthcare provider to see if there are any growths or signs of cancer.

Other visual exams include virtual computed tomography (CT) colonography and a flexible sigmoidoscopy; both of these procedures require five-year re-screening.

Novel options like the GI Genius intelligent endoscopy module are also available. They use artificial intelligence to help healthcare professionals find and treat polyps in the colon as a preventive measure.

Stool-Based Tests

Stool-based tests can check for hidden blood inside a person’s stool that could signal health issues, as well as changes in cellular DNA that might indicate cancer or precancerous conditions. These less invasive procedures need to be performed annually (or every three years for the DNA test).

If a stool-based test comes back with unexpected results, a follow-up colonoscopy is usually required to determine the source of the issue.

Lung Cancer

Men or women aged 55 or older should talk to a healthcare provider about their smoking history, and if screening for lung cancer would be advisable. Lung cancer is easier to treat when it's in its earliest stages.

You should get yearly lung cancer screenings if all of the following apply to you:

• A current or former smoker that has quit within the last 15 years
• A heavy smoker (or used to be)—that is, you have a 20-pack year smoking history (i.e. at least one pack a day for 20 years, two packs a day for 10 years, and so on)
• Age 50-80 years and doesn't have any symptoms

Previously, these screenings used regular chest X-rays, but low-dose CT scans (LDCT) are more accurate and have replaced X-rays in recent years. Scans are recommended yearly until the person turns 81 years old or has not smoked in 15 or more years, whichever comes first.

Screenings for Men

Men should talk to their healthcare provider about what cancer screenings they should receive, including tests to detect signs of prostate cancer.

Prostate cancer screenings are not recommended for all men. However, men should talk to their practitioners about whether prostate cancer screening is a good idea for them specifically. If your provider does recommend screening, they will likely suggest you get periodic prostate-specific antigen (PSA) tests.

PSA Test

Checking a patient’s prostate-specific antigen level through a PSA test is the most common way of checking for possible prostate cancer. As the level of PSA in the blood rises, the chance of prostate cancer occurring does as well, although there is no specific PSA threshold that clearly indicates the presence of cancerous cells.

A variety of factors can affect PSA. This makes a hard cutoff challenging to establish.

Follow-Up Tests

If a test does come back with an unusual PSA result, other exams will likely be necessary. One is a digital rectal exam (DRE), where a practitioner inserts a finger into the rectum to manually feel for any bumps or lumps that may be cancer.

Another is a prostate biopsy, where a piece of living tissue is removed and sent off for analysis. A prostate biopsy is the likely next step if either the PSA and/or DRE results are abnormal. However, your healthcare provider might also recommend you talk to a urologist or get an imaging test of the prostate gland.

Screenings for Women

Screenings women should receive involve testing for early signs of cervical and breast cancer.

Cervical Cancer

All women ages 25 through 65 who have a cervix should get screened for cervical cancer. Most kinds of cervical cancer are caused by the human papillomavirus (or HPV).

Regular screenings can identify lesions caused by HPV before they become cancerous (so they can be removed), and help detect other types of cervical cancers at early, more treatable stages. The kind of screening you should receive—and how often—will depend on your age and health history.

Screening tests to check for cervical cancer include:

• Pap test: This procedure involves taking a sample of cervical cells and sends them off to a laboratory to check for abnormal cells. If your pap test results come back negative, you can likely wait three years before getting another.
• HPV test: This is done similarly to a Pap test, but the sample of cervical cells will be tested for the presence of HPV. If your results come back normal, you might be able to wait five years before your next screening test.
• Pap test and HPV test: You may get both a Pap smear and an HPV test at the same time. If both tests come back clear, your healthcare provider will likely tell you that you can wait five years before being screened for cervical cancer again.

If tests come back abnormal, more tests may be necessary to determine the severity of the changes and the correct treatment steps.

Some women might need to be screened more or less often. For example, women who have certain risk factors such as a compromised immune system, having HIV, or having been previously treated for precancerous lesions or cervical cancer, may need testing more frequently.

Likewise, there is some evidence that screenings are less effective for obese women, due to difficulty accessing or visualizing the cervix. Women who have had total hysterectomies for reasons unrelated to cancer do not need screenings.

Breast Cancer

Recommendations for breast cancer screening can vary widely and are very dependent on age and personal risk factors. Generally speaking, however, women should talk to their healthcare provider about what their level of risk for breast cancer might be and how they could affect recommendations for screening.

Women who are considered to be at average risk for breast cancer should begin asking their healthcare provider about yearly screenings starting as early as age 40. After age 55, women can switch to exams every other year, or they can choose to continue yearly mammograms. 

You are at average risk if you have no personal or strong family history of the disease, no genetic mutations that cause an increased risk, and have had no radiation therapy before the age of 30.

Women who are at high risk for breast cancer should start yearly screenings much earlier, typically around age 30. These women include those with:

• A family history of breast cancer
• A known BRCA1 or BRCA 2 gene mutation or a first-degree relative with the mutation
• A history of radiation therapy to the chest between the ages of 10 and 30 years old
• A history of specific syndromes that increase the chances of developing certain cancers

Screenings should continue as long as a woman is in good health and has a life expectancy of over 10 years.

The most common screening tests for breast cancer are regular mammograms and clinical breast exams.

• A mammogram is an X-ray of the breast that can detect tumors that are not yet physically felt or tiny spots of calcium (called microcalcifications) that can sometimes indicate breast cancer. Two plates compress the breast tissue so the X-rays, which are lower doses than traditional X-rays, can get a clearer, more accurate image.
• Breast exams, both clinical and self-administered, are a thorough examination of breast tissue in search of lumps, pain, or any other unexpected changes. While these exams alone cannot detect cancer, being familiar with the appearance and feel of your breast tissue, you can more accurately detect when a change occurs.

Women with an increased risk for breast cancer may also need a yearly breast magnetic resonance imaging (MRI) in addition to a mammogram. The patient has contrast dye injected into the blood for maximum breast tissue contrast detail, and a specially-designed MRI machine is used.

Other Types of Cancer Screenings

There are many other types of cancer screenings, including ovarian, pancreatic, testicular, and thyroid. However, screenings for these types of cancers does not appear to reduce deaths from them. Screenings for oral cancer, bladder cancer, and skin cancer have not had enough evidence established to weigh the benefits and risks.

A Word from Verywell

If you're not sure what cancer screenings you might need, talk to your healthcare provider or a primary healthcare provider. They can help you better understand your personal risk factors and what screenings might be beneficial for you.