Table 1.
Recommendations for Cancer screening as suggested by the American Cancer Society.
| Screening exam | Recommendations (1999–2010) | ||
|---|---|---|---|
| Breast cancer screening | Mammography (an digital or film x ray picture of the breast) | Women ≥40 years should have mammograms every 1–2 years | |
| Women with a higher than average risk of breast cancer should discuss frequency of, and age at first screening with their health care providers | |||
| Clinical breast exam | Every 3 years for women in their 20s and 30s and every year for women ≥40 years | ||
| Cervical cancer screening | Pap test* | 1999 | Sexually active women or those ≥18 years, annual Pap test and pelvic examination. After more than 3 consecutive satisfactory normal annual examinations, the Pap test may be performed less frequently at the discretion of the physician |
| 2002 | At least 3 years after first vaginal intercourse, but no later than 21 years old, women should have regular Pap tests every 1 year or every 2 years with newer liquid-based test. Women ≥30 with 3 consecutive normal Pap test results may get screened every 2–3 years | ||
| Women >30 years may also get screened every 3 years with either the conventional or liquid-based Pap test, in addition to the human papillomavirus (HPV) test | |||
| Women ≥70 years with 3 or more consecutive normal Pap tests and no abnormal Pap test results in the last 10 years may discontinue testing | |||
| Women who have had a total hysterectomy for non-cancer related reasons may discontinue testing | |||
| 2009 | Screening should begin at age 21 | ||
| Women 21–29 years should have Pap test every 3 years. If Pap test result is abnormal then women should have a HPV test | |||
| Women 30–65 years should have both a Pap test and an HPV test every 5 years. It is also okay to have a Pap test alone every 3 years | |||
| Women >65 years who have had regular screenings with normal results should not be screened for cervical cancer | |||
| However those who have been diagnosed with cervical pre-cancer should continue to be screened | |||
| Colorectal screening | Men and women ≥50 years | ||
| Flexible sigmoidoscopy | Every 5 years†, or | ||
| Colonoscopy | Every 10 years, or | ||
| CT colonography (virtual colonoscopy) | Every 5 years† | ||
| Double-contrast barium enema | Every 5 years† | ||
| Fecal occult blood test (gFOBT) | Annually‡, or | ||
| Fecal immunochemical test (iFOBT/FIT) | Annually‡, or | ||
| Stool DNA test (sDNA) | Interval uncertain (possibly 3–5 years)‡ | ||
| Prostate cancer screening | Prostate specific antigen (PSA) blood test/velocity test [How PSA measures rise over time] | Discuss with physician the pros and cons of receiving a baseline PSA and follow-up test if necessary | |
| PSA density test [Ratio of PSA level to size of prostate gland] | Men at higher than normal risk (Blacks, men whose father, brother or son have been diagnosed with prostate cancer) discuss screening with physician at 45 years | ||
| Percent-free PSA [Ratio of unattached PSA in blood to total PSA] | Men ≥50 years discuss the harms and benefits of PSA screening with physician | ||
| Age-specific PSA range | Men with a previous PSA of ≥4 ng/ml in the blood, should be retested if discussion with physician dictates a necessity | ||
| Digital rectal exam | As recommended by physician | ||
*In 2009 the recommendation for cervical cancer screening changed to pap tests every three years beginning at age 21. Recommendations now include HPV testing every 5 years among women 30–65 years. HPV testing was not included in our analyses. †If test is positive, a colonoscopy should be done. ‡A single test done in the doctor’s office is not adequate for testing. A colonoscopy should be done if the test is positive.