Cancer Screenings: What Am I Due For And When?

Staying on top of routine cancer screenings is one of the best ways you can protect your long-term health. The reason routine cancer screenings are recommended is to detect certain cancers early, specifically cancers that often show now early signs or symptoms. Early detection is often the key to more effective treatments and certainly increases the likelihood of cure.

Here's a quick guide to some essential adult cancer screenings and other important health checks, including how often they’re recommended and who should get them.

Cancer Screenings for Adults

1. Breast Cancer Screening

• Who: Women ages 40 and older if average risk

• Screening: Mammogram

• Frequency: Annual (every year)

Breast cancer screening is usually done by annual mammogram although some women with dense breast tissue require ultrasound. If you have a gene that increases your risk of developing breast cancer, your provider may recommend you be screened every 6 months by ultrasound alternating with MRI. If you have a first degree relative with breast cancer (such as your mother or sister), we recommend starting your screenings when you are 10 years younger than the age of your relative at the time they were diagnosed. Your doctor can help you sort through when you should start and using what modality.
If you are at average risk, start with mammograms at 40.

2. Cervical Cancer Screening

• Who: Women ages 21–65

• Screening: Pap smear (plus HPV testing starting at age 30)

• Frequency:

  • Ages 21–29: Pap test every 3 years

  • Ages 30–65: Pap + HPV test every 5 years, or Pap alone every 3 years
    

Your gynecologist usually takes the lead on cervical cancer screening. If you are HPV positive or have some abnormality on your pap, you will need some further testing such as colposcopy and usually more frequent Paps in future.

3. Colorectal Cancer Screening

• Who: Adults ages 45*–75 (*this is a recent change in the USPSTF guidelines)

• Screening Options:

  • Colonoscopy (every 10 years)

  • Sigmoidoscopy (every 5 years)

  • FIT (Fecal Immunochemical Test) annually

  • Stool DNA test (e.g., Cologuard) every 3 years

Colon cancer screening is now recommended for adults ages 45 and older if you are at average risk (no family history). This is a recent change in the guidelines which previously recommended colon cancer screening for those over 50. The reason for the change is an increase in the number of cancers detected on first colonoscopy at the age of 50. Options for screening are plenty so there is no reason not to do it. The most simple is the FIT Test which is a stool test you collect at home and bring to the lab. It only tests for blood in the stool and, though it is easy, simple and cheap, it can lead to some false positives as it has no way if identifying bleeding from a cancerous spot versus bleeding from something simple like hemorrhoids. This is why this test is repeated every year. A positive FIT test is usually followed by a colonoscopy. The Cologuard or other stool DNA testing is much more specific and can detect genes associated with common types of colon cancers and is repeated every 3 years. Again, a positive stool DNA test has to be followed up with a colonoscopy. By far, the best testing for colon cancer screening is the colonoscopy. Colonoscopies are performed by gastroenterologists or colorectal specialists and usually involves a "cleanse" to empty your bowels. They are usually performed in outpatient endoscopy suites where you are put under light sedation and the doctor uses a camera on a scope to look directly at the bowel wall enabling him or her to visually inspect for abnormalities and remove any polyps if found. This certainly sounds more invasive but typically patients hate the prep more than the actual procedure. Remember that sedation we talked about? Don't worry you won't remember a thing. Though more involved, colonoscopy is by far the gold standard and best test as far as screening for colon cancer. IF you have a negative colonoscopy, you don't need another one for 10 whole years. If you have a polyp, you may have a recall in 5-7 years.

4. Prostate Cancer

• Who: Men ages 50–69 (or earlier for those at higher risk)

• Screening: PSA (Prostate-Specific Antigen) blood test

• Frequency: Every 1–2 years, depending on risk and results

Prostate cancer can be screened for with digital rectal exam and/or a blood test called prostate specific antigen (PSA). This is usually done once every year but there has been some controversy over whether or not all men should be screened routinely. Talk to your doctor to come up with a plan that makes sense for you.

5. Lung Cancer

• Who: Adults ages 50–80 with a 20 pack-year smoking history and currently smoke or quit within the past 15 years

• Screening: Low-dose CT scan

• Frequency: Annually if eligible

If you are currently a smoker or have quit within the last 15 years and are between ages 50-80, you may be eligible for lung cancer screening. This is done via low-dose radiation CT scan looking for lung nodules. This test can be done routinely every year or more often if suspicious nodules are found. You must have a "20-pack-year" smoking history under your belt which is the number of years you smoked multiplied by the average packes per day (ex 1 ppd x 20 years or 1/2 ppd x 40 years).

Other Important Screenings

6. Abdominal Aortic Aneurysm (AAA)

• Who: Men ages 65–75 who have ever smoked at least 100 cigarettes

• Screening: Abdominal ultrasound

• Frequency: One-time screening

• Why it matters: Early detection can prevent life-threatening rupture.

7. Glaucoma

• Who: Adults over age 40, especially those with risk factors (family history, diabetes, high eye pressure, or certain ethnic backgrounds)

• Screening: Comprehensive eye exam including eye pressure check

• Frequency:

  • Every 2–4 years starting at age 40

  • Every 1–2 years after age 60 or if at higher risk

8. Skin Cancer

• Who: All adults, especially those with fair skin, high sun exposure, or a family history of skin cancer

• Screening: Full-body skin check by a healthcare provider or dermatologist

• Frequency: Annually or during routine exams; more often if high risk

Screening recommendations can vary slightly based on your personal and family health history. Be sure to talk with your doctor about which screenings are right for you and when you should start.

Take Charge of Your Health. Early detection saves lives.

Stay well,

Sandra Koehn, DO