Early Detection & Cancer Screening Guidelines

Diagnosing cancer at its earliest stage often provides the best chance for a cure. With this in mind, talk with your Northwestern Lake Forest Hospital doctor about what types of cancer screening may be appropriate for you.

The American Cancer Society recommends the following guidelines for cancer screenings, so that potential cancer diagnosis is detected early enough to save lives. These guidelines are recommended for those people at average risk for cancer, unless otherwise specified:

• Early Detection Guidelines for Women
• Early Detection Guidelines for Men

Women should begin testing for breast or colorectal cancer earlier and/or undergo testing more frequently if at increased or high risk for these cancers. See all screening guidelines for breast cancer.

Men should begin testing for colorectal or prostate cancer earlier and/or undergo testing more frequently if at increased or high risk for these cancers.

Health counseling for tobacco use, sunscreen exposure, physical activity and nutrition, sexual practices, risk factors and environmental and occupational exposures should also be part of every check-up.

Age 20 to 29	At time of check-up:	Examination for cancer of the thyroid, oral cavity, skin, lymph nodes and ovaries.  Women should be told about the benefits and limitations of Breast Self-Exam (BSE).  Breast changes should be reported to the physician or nurse without delay. See all screening guidelines for breast cancer.
	Every three years:	Clinical breast exam
	One of the following (Cervical):+	Yearly conventional Pap test or every other year liquid-based Pap test
Age 30 to 39^	At time of check-up:	Examination for cancer of the thyroid, oral cavity, skin, lymph nodes and ovaries.  Women should be told about the benefits and limitations of BSE.  Breast changes should be reported to the physician or nurse without delay. See all screening guidelines for breast cancer.
	Every three years:	Clinical breast exam
	One of the following (Cervical):	If Pap testing history has been normal^^: Conventional or liquid-based Pap test every two to three years or Pap test with HPV DNA test every three years.
Age 40 to 49	At time of check-up:	Examination for cancer of the thyroid, oral cavity, skin, lymph nodes and ovaries.  Breast changes should be reported to the physician or nurse without delay.
	Every year:	Mammogram (continue as long as the woman is in good health) and clinical breast exam prior to mammogram. See all screening guidelines for breast cancer.
	One of the following (Cervical):	If Pap testing history has been normal^^: Conventional or liquid-based Pap test every two to three years or Pap test with HPV DNA test every three years.
	At menopause^ (Endometrial):	Women should be informed about risks and symptoms of endometrial cancer and strongly encouraged to report any unexpected bleeding or spotting to their doctor.
Age 50 and older	At time of check-up:	Examination for cancer of the thyroid, oral cavity, skin, lymph nodes and ovaries.
	Every year:^	Mammogram (continue as long as the woman is in good health). See all screening guidelines for breast cancer.
	One of the following (Cervical):	If Pap testing history has been normal^^: Conventional or liquid-based Pap test every two to three years or Pap test with HPV DNA test every three years.
	One of the following (Colon):	Yearly stool blood test*, or flexible sigmoidoscopy every five years, or yearly stool blood test plus flexible sigmoidoscopy every five years** or double-contrast barium enema every five years or colonoscopy every 10 years.

^ For women 35 and older, if at high risk for hereditary nonpolyposis colon cancer (HNPCC), yearly testing offered for endometrial cancer with endometrial biopsy.

+ Start about three years after beginning vaginal intercourse, but no later than 21 years of age.

^^ Cervical cancer testing should be done every year with a regular Pap test or every two years with the liquid Pap test if a woman hasn't had three normal Pap tests in a row.  Women 70 years of age and older who have had no abnormal Pap test in the last 10 years may choose to stop testing.

* Either the take-home multiple sample fecal occult blood test (FOBT) or the fecal immunochemical blood test (FIT) should be used.

** Stool blood test plus flexible sigmoidoscopy is preferred over either test alone.

Age 20 to 44	At time of check-up:	Examination for cancer of the thyroid, oral cavity, skin, lymph nodes and testes.
Age 45 to 49	At time of check-up:	Examination for cancer of the thyroid, oral cavity, skin, lymph nodes and testes.
	Every year:	Prostate-Specific Antigen (PSA) test and digital Rectal Examination (DRE) testing for men at high risk for prostate cancer (African-American men and men with a father, brother or son with prostate cancer at a young age).
Age 50 and older	At time of check-up:	Examination for cancer of the thyroid, oral cavity, skin, lymph nodes and testes.
	Every year:	PSA and DRE should be offered to average risk men.  Information should be provided about the benefits and limitations of testing, so that an informed decision can be made.  PSA and DRE for men at high risk.
	One of the following (Colon):	Yearly stool blood test*, or flexible sigmoidoscopy every five years, or yearly stool blood test plus flexible sigmoidoscopy every five years** or colonoscopy every 10 years.

* Either the take-home multiple sample fecal occult blood test (FOBT) or the fecal immunochemical blood test (FIT) should be used.

** Stool blood test plus flexible sigmoidoscopy is preferred over either test alone.