Screening exams can diagnose cancer at the earliest stages, when treatment will be the most effective. Texas Oncology recommends regular screening and/or self-exams for breast, prostate, colorectal, skin, testicular, lung, and cervical cancers based on guidelines below.
Adults at Every Age
- Keep an eye on your skin and check for changes in freckles, moles, and other skin markings once a month.
- Screening recommendations are for women with average risk. It is important to discuss with a physician your individual risk factors, including age, menopausal status, and family history to determine your screening needs.
- Women should check their breasts monthly for lumps or masses, skin changes such as redness, scaling, or dimpling, nipple discharge, or other changes.
- Men should check both testicles for hardened lumps and variations in size, shape, or consistency every month.
- Individuals should be aware of their cancer risk, which may be higher for those with a personal or family history of cancer, or certain genetic profiles that have been associated with specific cancer types. Screening may need to occur more often or begin at an earlier age for those with these risk factors.
- Research does not indicate the most appropriate age to begin cancer screening. Patients should consult a physician to make an informed decision about screening, considering the patient’s history and circumstances.
- Women with a first degree relative diagnosed with breast cancer before the age of 50 should begin receiving mammograms 10 years before reaching that relative’s age at diagnosis.
- Women with a family history of breast, ovarian, and/or other cancers should consider evaluation by a genetics counselor.
- Women who had a previous pelvic malignancy should consult with a physician regarding type and frequency of follow-up exams.
20s
- Women in their 20s should have a clinical breast exam every three years.
- Women should have a Pap test to screen for cervical cancer every three years beginning at age 21 and not before, regardless of whether they have received the HPV vaccine. The U.S. Preventive Services Task Force (USPSTF) recommends another option to screen with the high-risk human papillomavirus (hrHPV) test only every five years.
30s
- Women in their 30s should have a clinical breast exam every three years.
- Women in their 30s should have a Pap test and DNA HPV test every five years or only a Pap test every three years to screen for cervical cancer. The DNA HPV test, given in conjunction with a Pap test, may identify existing HPV infections that could lead to cervical cancer. Another option is to screen with the high-risk human papillomavirus (hrHPV) test only every five years.
- Women should discuss their breast cancer risk level with a physician to determine the most appropriate breast cancer screening options, including mammograms and MRI screening.
40s
- Women age 40 and older should discuss individual risk factors with a physician to determine recommended timing and most appropriate screenings, including an annual mammogram, an annual clinical breast exam, and annual MRI screening.
- Women in their 40s should continue to have a Pap test and DNA HPV test every five years or only a Pap test every three years to screen for cervical cancer. Another option is to screen with the high-risk human papillomavirus (hrHPV) test only every five years.
- Men with a high risk of prostate cancer (African Americans and men with a family history of prostate cancer before age 65) should discuss with a physician whether screenings are appropriate beginning at age 45.
- Men with a higher risk of prostate cancer (those with more than one first-degree relative diagnosed at an early age) should discuss screenings with a physician beginning at age 40. Men with the BRCA gene mutation also have an increased risk.
- Beginning at 45, both men and women should begin screening for colorectal cancer with one of the following: guaiac-fecal occult blood test (gFOBT) or fecal immunochemical test (FIT) annually; stool DNA (sDNA) test every three years; a flexible sigmoidoscopy, a double-contrast barium enema, or virtual colonoscopy every five years; or a colonoscopy every 10 years.
- People with increased colorectal cancer risk factors should consult a physician whether to begin screenings earlier than age 45.
50s through 70s
- Women age 50 and older should have a mammogram and a clinical breast exam at least every two years after discussion with her physician, and if recommended by a physician, an annual MRI screening.
- Women in their 50s should continue to have a Pap test and DNA HPV test every five years or only a Pap test every three years to screen for cervical cancer. Another option is to screen with the high-risk human papillomavirus (hrHPV) test only every five years. Women over age 65 should discuss her previous test results and the risks and benefits of screening with their physician.
- Beginning at age 50, men should discuss with a physician the benefits and risks of prostate cancer screening to make an informed decision about testing. Prostate cancer screening may involve a prostate-specific antigen (PSA) blood test and a digital rectal examination (DRE).
- People ages 55-74 with a history of heavy smoking, who smoke now, or who quit within the past 15 years, and have a 30-pack year smoking history are at a higher risk for lung cancer and should consider a yearly low-dose CT to screen for lung cancer.
80s and Beyond
- Men and women age 80 and older should consult a physician about the benefits and risks of cancer screenings.
Sources: American Cancer Society, American Society of Clinical Oncology. Centers for Disease Control and Prevention, National Cancer Institute, Testicular Cancer Society, Texas Oncology Physicians, and U.S. Preventative Services Task Force