February marks National Cancer Prevention Month, a time dedicated to raising awareness about the vital steps we can take to reduce the risk of cancer and promote a healthier future for ourselves and our communities. Below are screening guidelines for some of the most common types of cancer. Prioritizing these regular screenings can play a crucial role in catching cancer in an early stage when it’s the most treatable. Speak with your physician about which cancer screenings are appropriate for you.
Screening Guidelines for Lung Cancer
People who currently smoke or have smoked in the past have an increased risk of developing lung cancer. Lung cancer screening with a low-dose CT scan may be appropriate for those who meet the following criteria:
- Are aged 50 to 80
- Currently smoke or have smoked within the past 15 years
- Have at least a 20 pack-year smoking history
Lung cancer screening is recommended only for adults who are at high risk for developing the disease because of their smoking history and age, and who do not have a health problem that substantially limits their life expectancy or their ability or willingness to have lung surgery, if needed. Talk to your healthcare provider about the benefits and limits of lung cancer screening.
Screening for Dense Breast Tissue
If you have dense breast tissue, your physician may recommend a three-dimensional mammogram. Multiple X-ray images are taken of each breast at multiple angles without compressing the breast to avoid causing the tissue to overlap. These images are then digitally assembled to produce a clear three- dimensional image that makes any potential cancer easier to detect.
High Risk Breast Cancer Screening
Additionally, some women with certain risk factors for developing breast cancer may benefit from earlier and/or additional screening. The high-risk category includes those with:
- An increased risk of breast cancer as a result of genetics, including those with BRCA1 mutations
- A calculated lifetime risk of 20% or more
- Exposure to chest radiation at a young age
Women who are high risk for breast cancer are advised to have MRI surveillance starting at age 25 to 30. These women are also encouraged to begin annual mammograms at age 25 to 40, depending on their individual risk type.
Additionally, women diagnosed with breast cancer prior to the age of 50 or those who have a personal history of breast cancer and dense breasts should have annual supplemental breast MRIs. Women who are high risk but are unable to undergo MRI screenings should consider contrast-enhanced mammography.
Screening Guidelines for Colorectal Cancer
Regular colorectal cancer screening can detect precancerous polyps or colorectal cancer in its early stages, when it is easier to treat. Recommended screening guidelines for patients with an average level of risk include:
- Age 45-75: Patients at average risk (are in good health and with a life expectancy of more than 10 years) should continue regular colorectal cancer screenings.
- Age 76-85: The decision to be screened should be based on patient preference, life expectancy, overall health, and prior screening history.
- Age 86 and over: Should no longer get colorectal cancer screening.
Patients who are at an increased or high risk for colorectal cancer might need to start screening before the age of 45, be screened more often, and/or get specific tests. High-risk factors include:
- A personal history or a strong family history of colorectal cancer or certain types of polyps.
- A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease).
- A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous
polyposis (FAP) or Lynch syndrome (also known as hereditary non-polyposis colon cancer or HNPCC). - A personal history of radiation to the abdomen (belly) or pelvic area to re-treat a prior cancer.
Different testing methods exist for colorectal cancer screening. Recommendations for colorectal screening methods include:
Stool-based Tests
- 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
Visual (structural) Exams of the Colon & Rectum
- Colonoscopy every 10 years for average risk or more frequently based on personal and family history or if pathology identified.
- CT colonography (virtual colonoscopy) every 5 years or more frequently if pathology identified.
- Flexible sigmoidoscopy (FSIG) every 5 years or more frequently if pathology identified.
Screening Guidelines for Prostate Cancer
Prostate cancer screenings can detect cancer that may be at a high risk of spreading at an early stage, while it is easier to treat. Health care providers screen for prostate cancer by testing for prostate-specific antigen (PSA) levels in the blood. Prostate cancer can also be found through a digital rectal exam. If the results of prostate cancer screening are abnormal, further testing is often done to diagnose cancer.
Men considering prostate cancer screening should discuss the benefits, risks, and limitations of prostate cancer screening with their health care provider.
Currently, the American Cancer Society recommends the following screening guidelines based on risk level:
Average Risk:
- Age 50-69: Consider screening with a PSA for average risk patients. The decision to screen with PSA should be based on patient preference, family history, and current health.
- Age 70: Patients 70+ or with a life expectancy less than 10 to 15 years should not routinely be screened for prostate cancer.
High Risk:
- Age 45: Consider screening with PSA in high-risk populations including Black patients and those with a positive family history.
- Age 40: This includes patients who have more than one first-degree relative (father or brother) who had prostate cancer at an early age (younger than age 65) or patients with a genetic predisposition for prostate cancer (ex. BRCA1/2 positive, or other genes).
Please note that preventative screening guidelines are advised for individuals based on their sex assigned at birth. If a person has had surgical reassignment, they should discuss screening guidelines with their doctor.
