You’ve likely heard of colonoscopies and mammograms – both of these are types of cancer screening tests. But what you might not know is that there are other cancer screenings that may be recommended for you based on factors such as your age, sex and health.
It’s common to have questions about cancer screenings. How do they test for cancer? Do cancer screenings hurt? Who performs cancer screening tests? Below, I explain what a cancer screening is and answer the most common questions.
A cancer screening is a test to help catch cancer early
A cancer screening is a test to check your body for cancer cells. These screenings are done before you have any symptoms. The timing of the tests is based on your age, gender and risk factors.
The reason we recommend cancer screenings before you have symptoms is that many people don’t have symptoms of a disease when it’s in the early stages. By using routine screenings to test for cancer, we’re more likely to catch it early when it’s easiest to treat.
Preventive cancer screenings are recommended when there’s a clear benefit
Screening tests aren’t available for every type of cancer, but they are available for many of the most common cancers. For example, routine screenings for colorectal, breast, cervical and lung cancers are recommended because they find cancer early and save many lives. Prostate cancer screening may also be recommended, depending on your situation.
Preventive screenings generally aren't recommended for other types of cancer because the benefits of screening may not outweigh possible risks, such as false-positive results.
What cancer screening tests you may need and when
You may need different cancer screenings, depending on your age, gender, family history and other risk factors. Some, like mammograms and colonoscopies, are recommended for everyone of a certain age. Others are only recommended for people who are at higher risk of getting a certain type of cancer.
The following screenings may be recommended, but it’s best to talk to your doctor about what’s right for you.
Breast cancer screenings
All women (and those assigned female at birth) should start getting mammograms by the time they’re 40 years old. Once you start, it’s generally recommended that you get one every 1-2 years while you’re in good health. If you have a higher risk of developing breast cancer, your doctor might recommend starting before you turn 40, and that you get breast magnetic resonance imaging (MRI) in addition to a mammogram.
Cervical cancer screenings
Cervical cytology (commonly known as a Pap test) and human papillomavirus (HPV) tests are used for cervical cancer screening. Women (and those assigned female at birth) who are between ages 21 and 29 should get a cervical cytology every three years. When you reach age 30, your doctor may recommend that you get a HPV test in addition to cervical cytology. Between ages 30-65, screening is every 3 or 5 years, depending on the tests you get. Cervical cancer screening is usually done as part of a preventive exam.
Colorectal cancer screenings
Most people should get regular colorectal cancer screenings between ages 45 and 75. If you have risk factors for colon or rectal cancers, your doctor may recommend that you start screening sooner.
A colonoscopy is how we screen for cancer, but if you have an average risk of colorectal cancer, you may be able to start with a fecal immunochemical test (FIT). The FIT is a stool test that checks for gastrointestinal (GI) bleeding, which can be a sign of colorectal cancer or another GI disorder. If the FIT test is positive for blood, you’ll need a colonoscopy to confirm what’s causing the bleeding. Otherwise, the next step is usually to do another FIT test in a year.
Lung cancer screenings
Lung cancer screenings are generally recommended for people with a 20-pack year smoking history, between the ages of 50 to 80 who currently smoke or quit within the last 15 years. The recommended screening is a yearly low-dose CT scan.
To determine how many pack years you have, take the number packs (about 20 cigarettes) you smoke each day and multiply it by the number of years you’ve smoked. So, if you smoked one pack a day for 20 years, you have a smoking history of 20 pack years. You can also have a 20-pack history if you smoke two packs a day for 10 years.
Prostate cancer screenings
Prostate cancer screening is done with a prostate-specific antigen (PSA) blood test. The decision to have prostate cancer screening is usually based on factors such as age, ethnicity, family history and risk of gene mutations. Men (and those assigned male at birth) should talk to their doctor around age 45 about whether a screening is right for them. Your doctor may recommend one sooner – maybe in your 40s – if you’re African American or you have a family history of prostate cancer.
Types of cancer screenings by age and risk level
Types of cancer screening tests include imaging tests, blood tests, Pap tests and endoscopic procedures. In some situations, you may have a choice of testing options, depending on your health risks.
| Testing options | Normal risk age range | High risk age range* | Usual frequency | |
|---|---|---|---|---|
| Colon and rectal cancer | Colonoscopy | 45-75 years old | 40-75 years old | Every 10 years |
| FIT stool test** | 45-75 years old | Not applicable | Yearly | |
| Breast cancer (females only) | Mammogram | 40-74 years old | Before 40 years old | Every 1-2 years |
| Cervical cancer (females only) | Pap test | 21-65 years old | 21-65 years old | Every 3 years |
| Pap test + HPV | 30-65 years old | 30-65 years old | Every 5 years | |
| Lung cancer | Low-dose CT scan | Not applicable | 50-80 years old | Yearly |
| Prostate cancer (males only) | Possible PSA blood test | 45-75 years old | 40-75 years old | Every 2-3 years |
*Talk to your doctor about what age to start screenings if you are considered high risk.
**A FIT stool test doesn’t detect colorectal cancer but checks for hidden blood in the stool which can be a sign of colorectal cancer. If the test detects blood, a colonoscopy would be recommended as a follow-up test.
Risk factors that affect screening recommendations
Screening recommendations can be different, depending on your risk of cancer. Risk factors vary depending on the type of cancer but include your age, lifestyle, health and family history of cancer.
If you haven’t already, talk to your doctor about your risk factors for cancer. If you have a preventive care visit coming up, it’s probably fine to wait until then. If you don’t, it’s a good idea to make a primary care appointment.
Increased age
Being older is the biggest risk factor for cancer. The risk of developing cancer increases past the age of 40. This is especially true for certain types, including breast cancer, colorectal cancer and prostate cancer.
Tobacco and alcohol use
Using tobacco and drinking alcohol can greatly increase the risk of certain cancers. In fact, tobacco use is a leading cause of cancer and cancer deaths.
Using tobacco in any form increases the risk of cancers throughout the body, including lung, colon and rectum cancer. Drinking alcohol increases the risk of breast cancer and cancers of the mouth, throat and liver. The more alcohol you drink, the greater your risk.
Being overweight
Being overweight can increase your chance of developing certain types of cancer, including cancers of the breast, colon, rectum, kidney, pancreas and gallbladder. Losing even a small amount of weight, like 10% of your bodyweight, can help reduce your risk and improve your overall health.
Chronic inflammation
If you have chronic inflammation in your body, it can cause DNA damage that may lead to cancer. For example, having chronic inflammatory bowel disease can increase your risk of colon cancer.
Being on immunosuppression therapy
Taking medications that suppress your immune system makes it harder for your body to destroy cancer cells and fight off infections that cause cancer.
Genetics or a family history of cancer
Sometimes, cancer can be passed down through genes. Having a history of cancer in your family doesn’t mean that you will develop cancer, but it does put you at a higher risk. So, it’s important to update your doctor about cancer in your family, especially if things change. That way they can provide recommendations based on your current needs.
Genetic health screening studies
In Minnesota, myGenetics is a first-of-its-kind large-scale community health research study that screens your DNA for your genetic risk for cancers, including hereditary breast and ovarian cancer, and hereditary nonpolyposis colorectal cancer (Lynch syndrome). You can also get information on regional ancestry and traits like caffeine sensitivity.
This voluntary study is available at no cost to all HealthPartners and Park Nicollet patients over the age of 18 who do not have a history of a bone marrow or stem cell transplant from a donor. To participate, you’ll need to review and complete the myGenetics consent form and then visit one of our clinics to provide a blood or saliva sample. You can become a HealthPartners patient by scheduling an in-person appointment or video visit with one of our primary care doctors.
If you have a personal or family history of cancer, you can still participate in the myGenetics program. However, the genetic screening offered through myGenetics includes only a subset of genes that can cause an increased risk for cancer. If you have a personal or family history of cancer, you should review this information with your primary care provider or a genetic counselor to determine if more comprehensive genetic testing is recommended.
Commonly asked questions about cancer screenings
Who decides cancer screening recommendations?
Cancer screening recommendations come from the American Cancer Society and other organizations, including the U.S. Preventive Services Task Force (USPSTF), an independent, volunteer panel of national experts in preventive care. These organizations make screening recommendations based on the clinical evidence showing the benefits and risks of different preventive services. As we learn more about how cancer develops, cancer screening guidelines change. To learn more about screening guidelines, visit the USPSTF website.
Who performs cancer screenings?
It depends on the test. Some cancer screenings, like cervical cancer screenings (commonly called a Pap test), HPV tests and PSA blood tests, can be done by a primary care doctor during an annual physical. But other cancer screening tests, like colonoscopies and mammograms, are done by specialists during separate appointments. Your primary care doctor will provide information about how to get screened for cancer.
Do cancer screenings hurt?
While some screenings, like lung cancer screenings, are painless, others can cause some discomfort. Doctors and nurses do their best to keep you as comfortable as possible during screenings. And it’s important to remember that these screenings are an important part of maintaining your overall health and helping you find peace of mind.
I don’t have a family history of cancer. Why do I need a cancer screening?
Even though a family history of cancer increases your risk, it’s possible for anyone to develop cancer during their lifetime. Cancer screenings are recommended because they prevent cancer or catch it early. There’s evidence that early diagnosis can lead to better treatment outcomes. In some cases, like with breast cancer, cancer can be cured completely if caught early.
Are cancer screenings covered by insurance?
Most of the time, private health insurance, Medicaid and Medicare cover cancer screenings that are necessary based on current screening guidelines. Cancer screenings that are considered preventive care usually covered 100%.
Screenings for colorectal, breast, cervical and lung cancers are usually fully covered by all insurance plans when you meet certain criteria – for example, once you reach a certain age. But prostate cancer screening and other screenings may not be fully covered or covered at all. So if you get them, you may need to pay all or part of the cost, depending on your plan.
If you’re not sure what your insurance covers, use the information on the back of your insurance card to contact your insurance company. If you have HealthPartners insurance, you can contact member services.
How much does cancer screening cost without insurance?
If you don’t have insurance, you may be eligible for free or low-cost preventive cancer screenings. To learn about programs in your area, contact your local health department.
What happens if cancer is found during the screening?
If your doctor sees something concerning during a screening, they will guide you through the next steps. Depending on the condition, you might see an oncologist, a doctor who specializes in treating cancer, or another type of medical specialist. No matter what type of doctor you see, they will work with you to ensure you get personalized cancer care at every step of treatment and recovery.
How to get tested for cancer: Start by talking to your doctor
Getting your recommended cancer screening tests can help catch cancer early when it’s most treatable. So, they’re definitely worth getting!
To learn which screenings you need, ask your doctor at your next preventive care visit. Of course, if you have any concerning symptoms, it’s always best to see a doctor as soon as possible.