Cancer Site
|
Population
|
Test or Procedure
|
Frequency
|
| Breast |
Women, aged 20+ |
Breast self-examination (BSE) |
Beginning in their early 20s, women should be told about the benefits and limitations of breast self-examination (BSE). The importance of prompt reporting of any new breast symptoms to a health professional should be emphasized. Women who choose to do BSE should receive instruction and have their technique reviewed on the occasion of a periodic health examination. It is acceptable for women to choose not to do BSE or to do BSE irregularly. |
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|
Clinical breast examination (CBE) |
For women in their 20s and 30s, it is recommended that clinical breast examination (CBE) be part of a periodic health examination, preferably at least every three years. Asymptomatic women aged 40 and over should continue to receive a CBE as part of a periodic health examination, preferably annually. |
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|
Mammography |
Begin annual mammography at age 40.* |
| Colorectal |
Men and women, aged 50+ |
Fecal occult blood test (FOBT), or fecal immunochemical test (FIT) |
Annual, starting at age 50. |
|
|
Flexible sigmoidoscopy |
Every 5 years, starting at age 50. |
|
|
Fecal occult blood test (FOBT), or fecal immunochemical test (FIT), and flexible sigmoidoscopy |
Annual FOBT or FIT, and flexible sigmoidoscopy every 5 years, starting at age 50. |
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|
Colonoscopy |
Every 10 years, starting at age 50. |
|
|
Double contrast barium enema |
Every 5 years, starting at age 50. |
| Prostate |
Men, aged 50+ |
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, aged 18+ |
Pap test |
Cervical cancer screening should begin approximately three years after a woman begins having vaginal intercourse but no later than 21 years of age. Screening should be done every year with conventional Pap tests or every two years using liquid-based Pap tests. At or after age 30, women who have had three normal test results in a row may get screened every two to three years with cervical cytology (either conventional or liquid-based Pap test) alone, or every three years with an HPV DNA test plus cervical cytology. Women 70 years of age and older who have had three or more normal Pap tests and no abnormal Pap tests in the last 10 years and women who have had a total hysterectomy may choose to stop cervical cancer screening. |
| Endometrial |
Women, at menopause |
At the time of menopause, women at average risk should be informed about risks and symptoms of endometrial cancer and strongly encouraged to report any unexpected bleeding or spotting to their physicians. |
Cancer-related check-up
|
Men and women, aged 20+
|
On the occasion of a periodic health examination, the cancer-related checkup should include examination for cancers of the 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.
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| *Beginning at age 40, annual clinical breast examination should be performed prior to mammography. |
| FOBT for colorectal cancer screening, as it is sometimes done in physicians’ offices with the single stool sample collected on a fingertip during a digital rectal examination, is not an adequate substitute for the recommended at-home procedure of collecting two samples from three consecutive bowel movements, and 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. |
| Information should be provided to men about the benefits and limitations of testing so that an informed decision about testing can be made with the clinician’s assistance. |
