Cancer is the result of the uncontrolled growth and spread of abnormal cells within the body. Some of these abnormal cells can be discovered through a cancer screening. Preventative tests can lead to early detection of cancers, some of which if discovered early can be successfully treated. Resources available through Rutgers Cancer Institute of New Jersey and ScreenNJ describe risk factors and other information that can be useful in speaking to a health care provider about a screening schedule.
There are guidelines and recommendations by the American Cancer Society for each of the tests, which you may discuss with your healthcare provider.
The American Cancer Society has revised its cancer screening guidelines as of 06/09/2020, and the U.S. Preventive Services Task Force revised their guidelines for Lung Cancer Screening as of 03/08/2021. Please see the American Cancer Society's website at www.cancer.org for the latest updates.
Most tests are covered by medical insurance. If you do not have insurance then contact your local public health office for places you can go to for these services either at no cost or at a reduced cost.
The following guidelines describe cancer screening tests based on your age. Please note: your family medical history or your personal health issues can modify these screening guidelines.
Beginning at age 20, men and women may consider periodic health exams and a cancer-related checkup. The cancer checkup might include health counseling and exams for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries (depending on a person's age and gender).
Special tests for certain cancer sites are recommended by the American Cancer Society as outlined below:
- Women ages 40 to 44 should have the opportunity to begin annual breast cancer screening with mammograms.
- Women age 45 to 54 should get mammograms every year.
- Women 55 and older should switch to mammograms every two years, or can continue yearly screening.
- Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.
Women are encouraged to know how their breasts normally feel and report any breast changes promptly to their healthcare providers.
Some women at increased risk (for example, family history, genetic tendency, past breast cancer) should be screened with MRIs along with mammograms. (The number of women who fall into this category is very small.) Talk with your healthcare provider about your risk for breast cancer and the best screening plan for you.
Colon and Rectal Cancer
Beginning at age 45, people of average risk for colorectal cancer should follow one of these six testing schedules as recommended by your healthcare provider:
- Yearly guaiac-based fecal occult blood test (gFOBT)*
- Yearly fecal immunochemical test (FIT)*
- Multi-target stool DNA test every three years*
- Flexible sigmoidoscopy every five years*
- Colonoscopy every 10 years
- CT colonography (virtual colonoscopy) every five years*
* If the test is positive, a colonoscopy should be done.
If you are at high risk of colon cancer based on family history or other factors, you may need to be screened using a different schedule. Talk with your healthcare provider about your history and the testing plan that’s best for you.
A person in good health should continue regular screening through age 75.
For people ages 76-85, talk with your healthcare provider about whether continuing to get screened is right for you. When deciding, take into account your own preferences, overall health, and past screening history.
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- Cervical cancer screening should begin at age 21. Anyone under age 21 should not be tested.
- Women between the ages of 21 and 29 should have a Pap test every three years. HPV testing should not be used unless it is needed after an abnormal Pap test result.
- Women between the ages of 30 and 65 should have a Pap test and HPV test every five years (this is preferred) or have the Pap test alone every three years.
- Women over age 65 who have had regular cervical cancer testing in the past 10 years with normal results can stop being tested. Women with a history of cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing continues past age 65.
- Women who have had a total hysterectomy (removal of the uterus and cervix) can stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or precancer. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above.
- Women who have been vaccinated against HPV should still follow the above screening recommendations.
Some women, because of their health history (HIV infection, organ transplant, DES exposure, etc.), may need a different screening schedule for cervical cancer. Talk to your healthcare provider about your history.
Cervical Health Resource Center
Endometrial (Uterine) Cancer
The American Cancer Society recommends that at the time of menopause, all women should be informed about the risks and symptoms of endometrial cancer, and to report any unexpected bleeding or spotting to their healthcare providers. Some women, because of their history, may need to consider having a yearly endometrial biopsy. Please talk with your healthcare provider about your history.
The American Cancer Society recommends yearly lung cancer screening with a low-dose CT scan (LDCT) for certain people at higher risk for lung cancer who meet the following conditions:
- Are aged 50 to 74 years and in fairly good health
- Currently smoke or have quit smoking in the past 15 years
- Have at least a 20 pack-year smoking history. (A pack-year is 1 pack of cigarettes per day per year. One pack per day for 20 years or 2 packs per day for 10 years would both be 20 pack-years.)
Before getting screened, you should talk to your health care provider about:
- Your risk for lung cancer
- How you can quit smoking, if you still smoke
- The possible benefits, limits, and harms of lung cancer screening
- Where you can get screened
You should also talk with your insurance provider about your coverage.
For more information on Lung Cancer and screenings, visit our Lung Cancer Resource Center
The American Cancer Society recommends that men make an informed decision with their healthcare provider about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. The American Cancer Society believes that men should not be tested without learning about the risks and possible benefits of testing and treatment.
Starting at age 50, discuss the pros and cons with your healthcare provider about testing to decide if testing is the right choice for you.
If you are African American or have a father or brother who had prostate cancer before age 65, you should have this talk starting at age 45.
If you decide to be tested, you should have the PSA blood test with or without a digital rectal exam. How often you are tested will depend on your PSA level.
There is no official recommendation from the American Cancer Society for early detection of skin cancer, but most doctors will recommend checking your own skin once a month, especially if you are at a higher risk of developing skin cancer.
People are considered high risk if they:
- have weakened immune systems
- have had skin cancer previously
- have a strong family history of skin cancer (especially melanoma)
- have fair skin, blue or green eyes, or blonde, red, or light brown hair
- have autoimmune diseases such as lupus
- have inherited conditions such as xeroderma pigmentosum (XP) or nevoid basal cell carcinoma syndrome (Gorlin syndrome)
- have had an organ transplant
- are on medications that lower or suppress your immune system, or make your skin more sensitive to sunlight
- spend a lot of time outdoors
- live or vacation regularly in high-altitudes, or tropical/subtropical climates
If you fall into one of those categories, you should ask your doctor how often they recommend self-skin checks.
Research shows that certain types of cancer can be prevented. Rutgers Cancer Institute doctors explain more.
If you would like further information about clinical trials for preventing cancer, please call Rutgers Cancer Institute of New Jersey’s Office of Human Research Services at 732-235-7356, or search for a clinical trial online here. For additional information about nationwide cancer prevention trials, you can call the National Cancer Institute at 1-800-4-CANCER or visit their website at www.cancer.gov.
Where Can I Find Further Information?
The Resource and Learning Center
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National Cancer Institute
The American Cancer Society
American Institute for Cancer Research
National Institutes of Health
U.S. Preventive Services Task Force
National Center for Chronic Disease Prevention and Health Promotion