Risk Factors and Screening Patient Resource Area - Screening & Early Detection

A health exam should include cancer screening and early detection. This may include health counseling, and depending on a person's age and gender, might include exams for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries, as well as for some non-malignant diseases.

Breast Cancer

• Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
• Clinical breast exam (CBE) should be part of a periodic health exam, every 3 years for women in their 20s and 30s and yearly for women 40 and over.
• Breast self-exam (BSE) is an option for women starting in their 20s.
• Women at increased risk (family history, genetic tendency, past breast cancer) may need to begin having mammograms earlier, and possiblyhaving additional tests such as breast ultrasound or MRI.

• Women should begin cervical cancer screening about 3 years after they begin having vaginal intercourse, but no later 21 years of age. Screening should be done yearly with the regular Pap test or every 2 years using the newer liquid-based Pap test.
• Beginning at age 30, women who have had 3 normal Pap test results may decrease screening to every 2 to 3 years. Another option for women over 30 is to undergo the conventional or liquid-based Pap test, plus the HPV DNA test. Women who have certain risk factors such as diethylstilbestrol (DES) exposure before birth, HIV infection, or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use should continue to be screened annually.
• Women 70 years of age or older who have had 3 or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having cervical cancer screening. Women with a history of cervical cancer, DES exposure before birth, HIV infection or a weakened immune system should continue to have screening as long as they are in good health.
• Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or precancer. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines.

• yearly fecal occult blood test (FOBT)* or fecal immunochemical test (FIT)
• flexible sigmoidoscopy every 5 years
• yearly FOBT or FIT, plus flexible sigmoidoscopy every 5 years
• double-contrast barium enema every 5 years
• colonoscopy every 10 years

• a personal history of colorectal cancer or adenomatous polyps
• a strong family history of colorectal cancer or polyps (cancer or polyps in a first-degree relative [parent, sibling, or child] younger than 60 or in 2 first-degree relatives of any age)
• a personal history of chronic inflammatory bowel disease
• a family history of an hereditary colorectal cancer syndrome (familial adenomatous polyposis or hereditary non-polyposis colon cancer)