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Cancer Screening: What Tests Should You have, and When?

separator Having cancer screening tests is the best way to detect the disease as early as possible. But recent telephone surveys, which were part of the Health Information National Trends Surveys, conducted by the National Cancer Institute, showed that most Americans don't know when to start getting tested.

The survey was first conducted in 2002 to 2003, and then was repeated in 2005. The following tests are recommended for people who are at an average risk of cancer. If you're at higher risk for whatever reasons—family history, personal health history, etc.—your doctor will tell you whether you need to have these tests earlier or more frequently, or whether you should have other tests as well.

Mammograms starting age 40: The National Cancer Institute recommends that women age 40 and older have mammograms every 1 to 2 years to screen for breast cancer.

Clinical breast exam: This should be done by a health professional about every three years for women in their 20s and 30s and every year for women who are 40 and older.

Pap smears to screen for cervical cancer: The recommendation is that women should have a Pap test three years after starting to have sexual intercourse, but no later than age 21. According to the American Cancer Society, women should have a Pap smear every year if it's the regular Pap test and every 2 years if it's the new liquid test. After age 30, women who've had three normal Pap results in a row may get screened every 2 to 3 years. Women who are 70 and older who've had 3 normal Pap tests in a row and no abnormal results in the last 10 years may discuss with her doctor the option of having no more Pap tests.

Prostate cancer: Starting at age 50, men should have both the PSA blood test and a digital rectal exam performed by their doctor. Men who are at higher risk, depending on exactly how high the risk is, should start having these tests at age 40 or 45.

Colon and rectal cancer: The American Cancer Society recommends that at age 50, women and men should follow one of five testing schedules:

  • A fecal occult blood test (FOBT) every year (this is a take-home test for blood in the stool) or fecal immunochemical test (FIT)
  • Flexible sigmoidoscopy every five years
  • Yearly FOBT or FIT, plus flexible sigmoidoscopy every five years
  • Double contrast barium enema every five years
  • Colonoscopy every 10 years

Skin cancer: The best way to screen for skin cancer is to check your own skin frequently for moles, scaly patches and sores that don't heal. When examining moles, you'll want to follow the ABCD guidelines. "A" is an asymmetrical shape, "B" is border irregularity, "C" is color difference within a mole, and "D" is a diameter that's equal to or larger than a pencil eraser.

What about screening for other cancers?

At this point, there's no evidence to suggest that routine screening for other types of cancers, such as cancer of the lung, will decrease mortality from these cancers.

As we mentioned above, there are many factors that influence your risk of specific kinds of cancers. These include your race, ethnicity, lifestyle, family history and your own personal health history. To ensure that you get the cancer screening that's most appropriate for you, it's extremely helpful to see your doctor on a regular basis. You can discuss your health history and family history with your doctor to make informed decisions.

Prevention as important as screening

Getting screened to detect cancer early is invaluable, but the other, equally important aspect of cancer prevention is living a healthy lifestyle. The way you decide to live your life has a big impact on your risk of developing certain cancers. Maintaining a healthy weight, having a diet that's rich in fruits and vegetables (at least five servings per day), not smoking, getting exercise nearly every day, avoiding excess exposure to the sun; all of these things are important ways to keep your risk of cancer as low as possible.

The American Cancer Society; The National Cancer Institute; The U.S. Preventative Services Task Force
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