Knowing which cancer screenings you should schedule – and when – is often confusing. Medical authorities such as the U.S. Preventive Services Task Force, or USPSTF; the American Cancer Society, or ACS; and physicians disagree about which cancer screenings are necessary and at what age you should be screened.
Types of cancers and when to get screened, according to USPSTF and ACS:
- Breast cancer: Women between the ages of 40 and 74.
- – USPSTF recommends a mammogram every two years for women between the ages of 50 and 74; women with a family history or other risk factors may choose to start between the ages of 40 and 49. USPSTF does not recommend breast self-exams.
- – ACS recommends yearly mammograms starting at age 40; clinical breast exams every three years for women in their 20s and 30s and every year for women 40 and older. ACS recommends women in their 20s start breast self-exams.
- Cervix cancer: Women between the ages of 21 to 65.
– USPSTF recommends a Pap smear screening every three years for women ages 21 to 65.
– ACS recommends a Pap smear screening every three years for women ages 21 to 29; and a screening every five years for women ages 30 to 65. Women over 65 with a history of normal Pap tests should not be screened – but women diagnosed with a serious cervical pre-cancer should keep testing for at least 20 years after that diagnosis, even if testing continues past age 65.
- Colon/rectal cancer: Men and women between the ages of 50 and 75.
– USPSTF recommends a screening beginning at age 50, then screening every five years until age 75; and no screenings past age 75.
– ACS recommends the same.
- Lung cancer: Men and women between the ages of 55 and 75.
– USPSTF recommends an annual screening for lung cancer for people with a smoking history of 30 packs per year or more who currently smoke or have quit within the past 15 years.
– ACS recommends the same.
- Oral cancers: Men and women.
– USPSTF has no recommendation either for or against.
– ACS recommends regular dental checkups that include a comprehensive mouth exam; and for doctors to examine the mouth and throat as part of a routine cancer-related checkup.
- Prostate cancer: Men aged 50 and older.
– USPSTF does not recommend a prostate-specific antigen, or PSA-based, screening for prostate cancer.
– ACS recommends starting at age 50, men should talk to a doctor about the pros and cons of PSA testing in order to make an informed choice; and African-Americans, or men with a father or brother who had prostate cancer before age 65, should have this talk with a doctor at age 45.
- Skin cancer: Men and women.
– USPSTF has no recommendation either for or against.
– ACS recommends skin self-exams – and that doctors examine the skin carefully as part of a routine cancer-related check-up. QCBN
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By David C. Beyer, M.D., F.A.S.T.R.O., F.A.C.R.O., F.A.C.R. and Andrew K. David, M.D
David C. Beyer, M.D., F.A.S.T.R.O., F.A.C.R.O., F.A.C.R., is a board-certified radiologist and leader of the Cancer Centers of Northern Arizona Healthcare’s radiation oncology clinical team at Verde Valley Medical Center – Sedona Campus. He is also President of the Board of Directors of the American Society for Radiation Oncology. Dr. Beyer advises patients to speak with their healthcare providers about what screenings to have, since everyone’s individual risk factors are unique.
Andrew K. David, M.D., is a board-certified Radiation Oncologist at CCNAH located at Flagstaff Medical Center. Dr. David generally agrees with recommendations for screening from the ACS, but has concerns over the new recommendations from USPSTF regarding breast and prostate cancer screenings. Breast cancer and prostate cancer are the second leading causes of cancer deaths in women and men, respectively and feels the new recommendations from the USPSTF will lead to more patients avoiding screening for these diseases.