Cancer Site | Population | Test or Procedure | Frequency |
Breast | Women >20 years | Breast self-examination (optional) | Monthly, starting at age 20 |
Clinical breast examination | Every 3 years from ages 20–39 Annually, starting at age 40✫ |
Mammography | Annually, starting at age 40 |
Colorectal | Men and women, age 50+ years | Fecal occult blood test (FOBT)† or | Annually, starting at age 50 |
Stool DNA test (sDNA) or | Interval uncertain, starting at age 50 |
Flexible sigmoidoscopy or | Every 5 years, starting at age 50 |
Fecal occult blood test (FOBT) and flexible sigmoidoscopy‡ or | Annual FOBT and flexible sigmoidoscopy every 5 years, starting at age 50 |
Double-contrast barium enema (DCBE) or | Every 5 years, starting at age 50 |
Colonoscopy or | Every 10 years, starting at age 50 |
CT colonography | Every 5 years starting at age 50 |
Prostate | Men >50 years | Digital rectal examination (DRE) and prostate-specific antigen test (PSA) | The PSA test and the DRE should be offered annually, starting at age 50, for men who have a life expectancy of at least 10 years§ |
Cervix | Women age <21 | None | |
Women age 21–29 | Cytology alone | Every 3 years. HPV testing for screening should not be used |
Women age 30–65 | Preferred: HPV and cytology contesting | Every 5 years. HPV testing for screening not recommended for most clinical settings |
Acceptable: Cytology alone | Every 3 years |
Women age 65+ | None following adequate prior negative screening | History of CIN2 or greater diagnosis should continue screening for 20 years |
Women following hysterectomy and NO history of CIN2 or greater diagnosis | None | Applies only to women with: |
Women following hysterectomy and history of CIN2 or greater diagnosis | Continue age specific screening for at least 20 years | |
Women HPV vaccinated | Continue to follow age specific guidelines above for non-vaccinated women |
Cancer-related checkup | Men and women age 20+ years | | On the occasion of a periodic health exam, the cancer-related check-up should include examination for cancers of thyroid, testicles, ovaries, lymph nodes, oral cavity, and skin, as well as health counseling about tobacco, sun exposure, diet and nutrition, risk factors, sexual practices, and environmental and occupational exposures |
✫Beginning at age 40, annual clinical breast examination †FOBT or FIT as sometimes done in the physician's office, with the single stool sample on fingertip during a DRE is NOT recommended. Toilet bowl FOBT tests also are not recommended. In comparison with guaiac-based tests for the detection of occult blood, immunochemical tests are more patient-friendly and are likely to be equal or better in sensitivity and specificity. There is no justification for repeating FOBT in response to an initial positive finding ‡Flexible sigmoidoscopy together with FOBT is preferred compared with FOBT or flexible sigmoidoscopy alone ... |