Which Cancer Screenings Should You Be Getting?

During the height of the COVID-19 pandemic, millions of people in the United States delayed getting routine cancer screenings. Fortunately, data shows cancer screening rates are returning to pre-COVID levels but, even in the best of times, the number of people who are screened is lower than it should be. But what screenings should you get and when? The Centers for Disease Control and Prevention (CDC) encourages screening for breast, cervical, colorectal (colon), and lung cancers because early detection leads to better outcomes.

April is Cancer Control Month, which raises awareness for cancer prevention, detection, and treatment. Many people don’t realize that they are due for a cancer screening. Read the guidelines below to make sure you are up to date.

Breast Cancer Screening

Individuals should undergo breast cancer risk assessment by age 25 years and be counseled regarding potential benefits, risks, and limitations of breast screening in the context of their risk stratification. You and your doctor can work together to decide what’s best for you and we strongly encourage you to ask questions and share your concerns. Our providers recommend that women who are at least 40 years old and are at average risk for breast cancer get a mammogram annually.

Cervical Cancer Screening

The HPV test and the Pap test can help prevent cervical cancer or find it early.

• The HPV test looks for the virus (human papillomavirus) that can cause cell changes on the cervix.
• The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately.

You should start getting Pap tests at age 21. If your Pap test result is normal, your doctor may tell you that you can wait three years until your next Pap test.

If you are 30 to 65 years old, talk to your doctor about which testing option is right for you:

• An HPV test only. This is called primary HPV testing. If your result is normal, your doctor may tell you that you can wait five years until your next screening test.
• An HPV test along with the Pap test. If both of your results are normal, your doctor may tell you that you can wait five years until your next screening test.
• A Pap test only. If your result is normal, your doctor may tell you that you can wait three years until your next Pap test.

If you are older than 65, your doctor may tell you that you don’t need to be screened for cervical cancer anymore if:

• You have had normal screening test results for several years, and
• You have not had a cervical precancer in the past, or
• You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.

Colon Cancer Screening

It is now recommended that regular screening, beginning at age 45, is the key to preventing colorectal cancer and finding it early. Colorectal cancer is the second most common cause of cancer death in the United States, and it is the leading cause of cancer-related deaths in men younger than 50. Most people should get a colonoscopy at least once every 10 years. You may need to get one every 5 years after you turn 60 if your risk of cancer increases.

Stool-based tests are becoming more popular because they are done at home, so many people find them easier than a colonoscopy. But, although these tests are easier to implement, they need to be done more often. If the result from a stool test is abnormal, a timely colonoscopy is required to check for cancer.

Lung Cancer Screening

We recommend annual lung cancer screening for people who:

• Have a 20 pack-year or more smoking history, and
• Smoke now or have quit within the past 15 years, and
• Are between 50 and 80 years old.

A 20 pack-year is smoking an average of one pack of cigarettes per day for one year. For example, a person could have a 20 pack-year history by smoking one pack a day for 20 years or two packs a day for 10 years. Talk to your doctor about lung cancer screenings if you have regular exposure to second hand smoke.

Lung cancer screenings can stop when the person being screened:

• Turns 81 years old, or
• Has not smoked in 15 or more years, or
• Develops a health problem that makes him or her unwilling or unable to have surgery if lung cancer is found.

Ask your doctor which cancer screenings are right for you and if you have concerns about cancer, you should talk to your healthcare provider as soon as possible.

Author

Robert Rice, MD, PhD is the executive medical director of oncology at Luminis Health, with more than 20 years of oncology experience.