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

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 40 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

Lung cancer

Low-dose computed tomography (CT)

ACS: Yearly in people between ages 50 and 80 years who smoke or who quit smoking and have at least a 20-pack-year history of smoking