Screening Procedures in Average-Risk* Asymptomatic People as Recommended by the American Cancer Society (ACS), US Preventive Services Task Force (USPSTF), and American College of Physicians (ACP)†

Type of Cancer	Procedure	Frequency
Breast cancer	Mammography	ACS: Recommended at the following ages: 40 to 44: Optional 45 to 54: Yearly ≥ 55: Every 1 to 2 years, continued as long as women are expected to live ≥ 10 years USPSTF: Every 2 years for women ages 50 to 74 ACP: Recommended at the following ages: 40 to 49: Optional, after discussing potential benefits and harms (but for most women, harms outweigh benefits) 50 to 74: Every 2 years ≥ 75 or women with a life expectancy of 10 years or less: Discontinue screening
Cervical cancer	Papanicolaou (Pap) test and/or human papillomavirus (HPV) test	ACS: Recommended at the following ages: < 25: No screening tests 25–65: HPV test alone every 5 years or Pap test plus HPV test every 5 years or Pap test every 3 years > 65: No testing if previous testing was done and results were normal USPSTF: Recommended at the following ages: 21 to 29: Cervical cytology alone every 3 years 30 to 65: Cervical cytology alone every 3 years or human papillomavirus (HPV) testing alone or combined with cytology (co-testing) every 5 years. > 65: No testing if previous testing was done and results were normal
Prostate cancer	Blood test for PSA (prostate-specific antigen)	ACS: Because the benefit of screening is uncertain, patient and physician should discuss the potential harms and benefits of prostate cancer screening beginning at age 50 (age 45 for African Americans or those who have a father or brother who had prostate cancer before age 65) USPSTF: The patient and physician should discuss the potential harms and benefits of prostate cancer screening beginning at age 55, but recommends against screening at age 70 or older.
Colorectal cancer	Stool testing: Fecal immunochemical test (FIT), high-sensitivity guaiac fecal occult blood test (gFOBT), or multi-target stool DNA test or Colonoscopy or Flexible sigmoidoscopy (with or without periodic FIT) or CT colonography	ACS: Ages for screening: Begin at age 45 and continue until age 75; at ages 76-85, individualize recommendation (eg, based on general health, life expectancy, and patient preferences) ACS: Screening tests: FIT or gFOBT every year or Multi-target stool DNA test every 3 years, or Colonoscopy every 10 years, or CT colonography or flexible sigmoidoscopy every 5 years USPSTF: Ages for screening: 45 to 75; individualize for ages 76 to 85. USPSTF: Screening tests: Same as ACS, as well as flexible sigmoidoscopy every 10 years plus FIT every year ACP: Ages: Recommended for ages 50 to 75; not recommended for age > 75 or with life expectancy < 10 years ACP: Screening tests: FIT or gFOBT every 2 years, or Colonoscopy every 10 years, or Flexible sigmoidoscopy every 10 years plus fecal immunochemical testing every 2 years
* Patients at high-risk of certain cancers may need to be screened according to a different schedule. For example, the ACS recommends that patients ages 55 to 74 at high risk for lung cancer, such as smokers with a 30 pack year history, who have smoked withing the last 15 years, and who are otherwise in good health, undergo periodic screening with low dose CT. The USPSTF recommends similar screening until age 80.
† Examinations for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries should also be done during routine medical care.
Modified from the recommendations of the United States Preventative Services Task Force (USPSTF), the American Cancer Society (ACS), the American College of Physicians (ACP) recommendations for breast cancer and colon cancer screening.

Type of Cancer

Procedure

Frequency

Breast cancer

Mammography

ACS: Recommended at the following ages:

40 to 44: Optional
45 to 54: Yearly
≥ 55: Every 1 to 2 years, continued as long as women are expected to live ≥ 10 years

USPSTF: Every 2 years for women ages 50 to 74

ACP: Recommended at the following ages:

40 to 49: Optional, after discussing potential benefits and harms (but for most women, harms outweigh benefits)
50 to 74: Every 2 years
≥ 75 or women with a life expectancy of 10 years or less: Discontinue screening

Cervical cancer

Papanicolaou (Pap) test and/or human papillomavirus (HPV) test

ACS: Recommended at the following ages:

< 25: No screening tests
25–65: HPV test alone every 5 years or Pap test plus HPV test every 5 years or Pap test every 3 years
> 65: No testing if previous testing was done and results were normal

USPSTF: Recommended at the following ages:

21 to 29: Cervical cytology alone every 3 years
30 to 65: Cervical cytology alone every 3 years or human papillomavirus (HPV) testing alone or combined with cytology (co-testing) every 5 years.
> 65: No testing if previous testing was done and results were normal

Prostate cancer

Blood test for PSA (prostate-specific antigen)

ACS: Because the benefit of screening is uncertain, patient and physician should discuss the potential harms and benefits of prostate cancer screening beginning at age 50 (age 45 for African Americans or those who have a father or brother who had prostate cancer before age 65)

USPSTF: The patient and physician should discuss the potential harms and benefits of prostate cancer screening beginning at age 55, but recommends against screening at age 70 or older.

Colorectal cancer

Stool testing: Fecal immunochemical test (FIT), high-sensitivity guaiac fecal occult blood test (gFOBT), or multi-target stool DNA test

Colonoscopy

Flexible sigmoidoscopy (with or without periodic FIT)

CT colonography

ACS: Ages for screening: Begin at age 45 and continue until age 75; at ages 76-85, individualize recommendation (eg, based on general health, life expectancy, and patient preferences)

ACS: Screening tests:

FIT or gFOBT every year or
Multi-target stool DNA test every 3 years, or
Colonoscopy every 10 years, or
CT colonography or flexible sigmoidoscopy every 5 years

USPSTF: Ages for screening: 45 to 75; individualize for ages 76 to 85.

USPSTF: Screening tests: Same as ACS, as well as flexible sigmoidoscopy every 10 years plus FIT every year

ACP: Ages: Recommended for ages 50 to 75; not recommended for age > 75 or with life expectancy < 10 years

ACP: Screening tests:

FIT or gFOBT every 2 years, or
Colonoscopy every 10 years, or
Flexible sigmoidoscopy every 10 years plus fecal immunochemical testing every 2 years

* Patients at high-risk of certain cancers may need to be screened according to a different schedule. For example, the ACS recommends that patients ages 55 to 74 at high risk for lung cancer, such as smokers with a 30 pack year history, who have smoked withing the last 15 years, and who are otherwise in good health, undergo periodic screening with low dose CT. The USPSTF recommends similar screening until age 80.

† Examinations for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries should also be done during routine medical care.

Modified from the recommendations of the United States Preventative Services Task Force (USPSTF), the American Cancer Society (ACS), the American College of Physicians (ACP) recommendations for breast cancer and colon cancer screening.

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Cancer Screening