Cancer screening recommendations


Each year, nearly 1.4 million new cases of cancer are diagnosed in the United States, a figure that does not include the 900,000 cases of skin cancer diagnosed annually.

Cancer is the second leading cause of death (after heart disease) in the United States, accounting for 560,000 deaths every year.

Fortunately, for certain forms of the disease, there are screenings that can detect cancer in its earliest stages. The specialists at Dana-Farber Cancer Institute have developed the following cancer screening recommendations for use in concert with your local health care provider.

Colorectal cancer
Lung cancer
Oral cancer
Skin cancer
Breast cancer
Cervical cancer
Prostate cancer 

Colorectal cancer

In colorectal cancer, one of the most treatable forms of cancer when detected early, cancer cells grow in the colon, rectum, or both.

Factors that place a person at higher risk for colorectal cancer are:

  • Age. According to the American Cancer Society, more than 90 percent of colorectal cancer cases are diagnosed in people over the age of 50.
  • Polyps. Benign growths of the colon and rectum increase your risk, particularly if this is an inherited condition.
  • Family history. If a first-degree relative in your family — a parent, sibling, or child — has had colon cancer or polyps, you are at higher risk.
  • Diet. A diet high in red meat fats will increase your risk of colorectal cancer.

Screening recommendations

Ages 18-34: Screening is usually not required.
Ages 35-49: Review risks and needs annually with your health care provider.
Ages 50+: You should have an annual stool occult blood test, as well as screening with flexible sigmoidoscopy or colonoscopy, as determined by your health care provider, based on your risk profile.

Lung cancer

The number-one risk factor for lung cancer is smoking. If you smoke, you should quit.

Aside from smoking, you are at increased risk of lung cancer if you have had:

  • prior surgery for another lung cancer;
  • occupational exposure to asbestos;
  • prolonged exposure to high levels of radon.

Screening recommendations

Currently, there is no standardized recommendation for lung cancer screening. Based on your risks, you should discuss the need for specific tests, such as a chest x-ray or chest CT, with your health care provider. Dana-Farber is conducting on-going clinical research to determine if certain tests would be reliable for screening.

Oral cancer

The oral cavity is made up of various parts of the mouth including the lips, lip and cheek linings, teeth, tongue, gums, and jaw. Oral cancer can affect any or all of these areas. The number of new cases of oral cancer, as well as the number of deaths from oral cancer, has been decreasing.

Factors that place a person at higher risk for oral cancer are:

  • Tobacco and alcohol use. The use of cigarettes, pipes, cigars, and smokeless tobacco is responsible for most cases of oral cancer. Alcohol, particularly beer and hard liquor, are associated with an increased risk of developing oral cancer. Avoiding or stopping the use of tobacco and alcohol will decrease the risk of oral cancer.
  • Diet. A diet low in fruits, vegetables, and fiber may increase the risk of oral cancer.
  • Age. The risk of developing oral cancer increases after 45 years of age.
  • HPV Infection. Certain strains of the human papillomavirus (HPV) may increase the risk of oral cancer.

Screening recommendations

Ages 18+: Yearly as part of a dental exam.

Vaccination to prevent HPV infection: The Centers for Disease Control (CDC) recommends vaccination for girls and young women between the ages of 13 - 26; the recommendation for boys and young men is ages 13 - 21. However, both males and females may be given the vaccination as early as ages 9 - 12 to prevent HPV infection.

CDC Vaccine Information Statement 

Skin cancer

Skin cancer statistics show that one in five Americans develops skin cancer, and every hour one American dies of the disease.

Skin cancer is caused most often by overexposure to the sun and its ultraviolet (UV) rays. It is important to practice proper sun protection to reduce your risk of skin cancer.

Your risk of developing skin cancer is increased if you:

  • have light skin color (fair-skinned people with blond or red hair and blue or light-colored eyes have a greater risk of developing skin cancer than dark-skinned people);
  • freckle easily;
  • have had frequent, severe sunburns;
  • live in an environment with high degrees of sun exposure;
  • have an inability to tan;
  • have a family history of skin cancer.

Screening recommendations

Ages 18+: Monthly self-exam of moles and birthmarks and by physician at general physical.

Breast cancer

Breast cancer is the second leading cause of cancer death in American women. The promising news is that most women diagnosed with breast cancer at an early stage survive and continue to live normal lives.

Factors that place a person at higher risk for breast cancer are:

  • Sex. Being a woman is the leading risk factor for breast cancer, primarily because of the complex hormonal changes that occur during a woman's lifetime.
  • Age. As you age, your chance of getting breast cancer increases.
  • Family history. If you have a mother, sister, or daughter who has had breast cancer, you are at double the risk for the disease. A family history of breast or ovarian cancer on the father's side can also increase breast cancer risk.
  • Reproductive health history. Longer-term exposure to estrogen affects your risk of breast cancer. You are at higher risk if you had your first period before age 12 or reached menopause after age 55.
  • Ethnic or racial background. Caucasian women have the highest risk, followed by African-American and Hawaiian women. Hispanic-American and Asian-American women appear to have the lowest risks.
  • Hereditary breast cancer. Multiple relatives with breast or ovarian cancers, especially diagnosed at young ages, may suggest inherited breast cancer risk. However, only five to 10 percent of breast cancer is associated with a mutation in a strong gene.
  • Previous findings. If you have previously had breast cancer or a breast biopsy that showed irregular changes, you may be at increased risk for breast cancer.
  • Hormone replacement therapy. The use of hormone replacement therapy in the form of estrogen and progesterone for longer than five years places you at a slightly higher risk for breast cancer.
  • Not having children or having children later in life. If you never have given birth or have delivered your first child after age 30, you are at increased risk.
  • Alcohol consumption. Drinking wine, beer, and hard liquor have been shown to elevate the amount of estrogen in a woman's blood. Anything that increases your long-term exposure to estrogen increases your risk of breast cancer.
  • Being overweight. Depending on several other factors, having excess weight can increase your risk of breast cancer.

Screening recommendations

Ages 18-34: Physician exam at general physical; mammogram usually not required.*
Ages 35-49: Physician exam at general physical; mammogram yearly after age 40, as reviewed with physician.*
Ages 50+: Physician exam at general physical; mammogram yearly.*

*Women with a family history of breast cancer may need to start mammography earlier. It's important to discuss your risk for breast cancer with your health care provider and make a plan for prevention together.

Cervical cancer

The number of American women who die annually from cervical cancer has decreased steadily over the past 40 years, due in large part to the Pap screening test.

You are at high risk for cervical cancer if you:

  • had exposure to DES (diethylstilbestrol, a synthetic hormone) that was given to your mother while she was pregnant with you;
  • have had a history of genital warts (condyloma);
  • have had a prior abnormal Pap test;
  • are being treated with immunosuppressive medications;
  • have had a history of high-risk HPV strain;
  • are a current smoker.

Screening recommendations

Ages 18-34: Pelvic exam every one to three years; after three consecutive normal tests, a Pap test can be performed every one to three years based on baseline results.
Ages 35-49: Pelvic exam and Pap test every one to three years, based on physician review.
Ages 50+: Pelvic exam and Pap test every one to three years, based on physician review until age 65; after age 65, based on physician recommendation.

Vaccination to prevent HPV infection: The Centers for Disease Control (CDC) recommends vaccination for girls and young women between the ages of 13 - 26; the recommendation for boys and young men is ages 13 - 21. However, both males and females may be given the vaccination as early as ages 9 - 12 to prevent HPV infection.

CDC Vaccine Information Statement 

Prostate cancer

Affecting one out of every six men, prostate cancer can begin as a localized tumor in the prostate gland but can spread. It is the second most common type of cancer found in American men.

Factors that place a person at higher risk for prostate cancer are:

  • Age. The disease is most often found in men over the age of 50; risk increases as they get older.
  • Race. The disease is about twice as common in African-American men than in Caucasian men.
  • Diet. Men who eat a high-fat diet are at higher risk.
  • Exercise. A man's risk of prostate cancer is increased if he does not exercise regularly and if he does not maintain a healthy weight.
  • Family history. Studies have shown that a man's risk is doubled if his father or brother has the disease.

Screening recommendations

Ages 18-34: Usually not required.
Ages 35-49: Usually not required; rectal prostate exam at 40 for high-risk men (African-Americans or with a family history of prostate cancer).
Ages 50+: Rectal prostate exam yearly; discuss PSA with your physician.


 
  • Email
  • Print
  • Share
  • Text
Highlight Glossary Terms
  • Ask the Cancer Genetics Team

    • Do you have questions about genetic testing or are you wondering if you or someone in your family is at greater risk of developing cancer? Our cancer genetics team can help answer your questions.
     
  • Cancer Prevention and Risk Reduction