Cancer Screening and Preventive Care Guidelines

Women Ages 20-39

The American College of Obstetricians and Gynecologists recommends cervical cancer screening to begin approximately 3 years after initiating vaginal intercourse, but no later than age 21, performed annually with conventional Pap tests or every 2 years with liquid-based Pap tests 1, 2, 3
Clinical breast examination (CBE) should be performed every 3 years as part of periodic health examination 2, 4
Breast self-examination (BSE) is optional; women should be educated about breast symptoms and the importance of prompt reporting of any new changes 4, 5

The American Cancer Society recommends annual mammography to begin at age 40 1, 2, 4
Annual clinical breast examination should be performed prior to mammography 1, 4
Continue annual Pap tests with conventional method or every 2 years with liquid-based tests 1, 2, 4

The American Cancer Society recommends annual mammography 1, 2, 4, 6
Choose one of the following options for colorectal cancer screening: annual fecal immunochemical test (FIT) or high-sensitivity guaiac-based fecal occult blood test (gFOBT), colonoscopy every 10 years, flexible sigmoidoscopy every 5 years, CT colonography every 5 years, double-contrast barium enema every 5 years, or stool DNA test (interval uncertain) 1, 2, 6
At or after age 30, women with 3 consecutive normal tests may be screened every 2-3 years with Pap test alone, or every 3 years with HPV DNA test plus Pap test 1, 2, 4, 6

Women aged 70+ with 3 or more normal Pap tests and no abnormal tests in the last 10 years may choose to stop cervical cancer screening 1, 2, 4
Women who have had total hysterectomy (with cervix removal) for benign reasons may discontinue cervical cancer screening 6

Examination for cancers of the thyroid, testicles, lymph nodes, oral cavity, and skin every 3 years from ages 20-39, then annually after age 40 2, 4, 7

The American Cancer Society recommends the PSA test and digital rectal examination (DRE) to be offered annually starting at age 50 for men with life expectancy of at least 10 years, after discussing benefits and limitations to allow informed decision-making 1, 2, 4, 6
Choose one of the following options for colorectal cancer screening: annual FIT or high-sensitivity gFOBT, colonoscopy every 10 years, flexible sigmoidoscopy every 5 years, CT colonography every 5 years, double-contrast barium enema every 5 years 1, 2, 6

Prostate cancer screening only if life expectancy exceeds 10 years 1, 2, 4
Depression screening annually 6
All positive results on non-colonoscopy colorectal screening tests require timely colonoscopy follow-up 6