Cancer screening refers to tests that can be done to:
There are 3 types of cancer screening tests:
Cancer screening saves lives. There have been many advances in cancer treatment over the past few years, and early treatment often cures the cancer. Many people live full, long lives after having cancer. Often this is because their cancer was diagnosed and treated very early. For example, a small breast cancer may be seen on a mammogram up to 2 years before you can feel it. The cancer can then be treated early, increasing the chances for cure.
Screening tests that have been shown to have benefit are:
Healthcare providers may also offer a yearly rectal exam and PSA blood test to screen men age 50 to 75 for prostate cancer. There is not enough evidence that screening all men for prostate cancer is helpful.
Mammogram
Comparing mammograms from year to year can help detect early cancer. Breast cancer screening guidelines released by the US Preventive Services Task Force (USPSTF) in 2009 recommend a mammogram every 2 years for women 50 to 74 years old. This recommendation is for women with average risk. Some women with a high risk of breast cancer may need to start screening earlier than age 50. The USPSTF recommendation is controversial and is being reviewed. For example, the American Cancer Society currently recommends that women age 40 and older should have a mammogram every year. Discuss your personal and family history of cancer with your healthcare provider. Together you can decide when you should start having mammograms and how often you should have them.
Pelvic exam and Pap test
A pelvic exam is a checkup of the female organs: the cervix, uterus (womb), vagina (birth canal), ovaries, and fallopian tubes. Pap tests are done during a pelvic exam to check for abnormal changes in the cells of the cervix. (The cervix is the opening of the uterus.) How often a woman should have a Pap test depends on her age and previous test results. Women should have their first Pap test at age 21 and keep having Pap tests at least every 2 years until they are 30. Some women may need to have the test more often. Women 30 or older should talk to their healthcare provider about how often they need the test.
Fecal occult blood testing (FOBT or FIT), sigmoidoscopy, and colonoscopy
If you are 50 to 75 years old and have an average risk of colon cancer, you may have:
The fecal occult blood test is done at home with a kit provided by your healthcare provider. Usually you will then take or mail the samples to your provider or the lab. If lab tests find blood in the samples, it does not necessarily mean you have cancer. It means you will need more tests to see what is causing the bleeding.
Sigmoidoscopy and colonoscopy are procedures that look for precancerous or cancerous growths in the colon and rectum. A lighted tube with a camera is inserted into the rectum to look inside your bowel. Sometimes a special X-ray test called a barium enema may be done instead of a sigmoidoscopy or colonoscopy to look for colon cancer.
You may need to start colorectal cancer screening earlier than age 50 if someone in your immediate family has had colon cancer, especially if their cancer occurred before they were 50 years old. Discuss this with your healthcare provider.
Digital rectal exam and PSA test
Healthcare providers may offer a yearly rectal exam and PSA blood test to men age 50 to 75 to screen for prostate cancer. African American men (who have the highest rate of prostate cancer in the US) and men who have a history of prostate cancer in their families should consider prostate cancer screening before age 50.
For the digital rectal exam, the healthcare provider puts a gloved finger in a man's rectum to feel the prostate gland. Prostate cancers feel very hard compared to normal prostate tissue. If your provider feels something abnormal, then you may have other tests to see if there is a tumor and whether it is a type of cancer that will spread.
The PSA (prostate specific antigen) level in the blood usually rises when a man has cancer of the prostate gland. However, it also rises if the prostate is infected or enlarged. Enlarged prostates are common in middle age and later. This means that the test can give misleading results. It can cause anxiety, expense, and unnecessary medical procedures. For this reason, the PSA test is not recommended as a general screening test for all men.
Research is ongoing to see when and how PSA is helpful as a screening test for prostate cancer. You should discuss your personal and family medical history with your provider to see if you should have prostate cancer screening.
Which tests you have and the timing of these tests depends on your personal and family history. Be sure your healthcare provider knows your family history. Ask your provider which cancer screening tests you need and how often you need them. Also be sure to have an exam by your healthcare provider every year.
