How to Find Cancer Early

Writer: Jillian Foglesong Stabile, MD, FAAFP, DABOM

According to the National Cancer Institute, more than 2 million people will likely be diagnosed with cancer in the United States in 2025.^[1] Cancer is the second leading cause of death both in the United States and worldwide.^[2] For most cancers, the earlier they are found, the easier they are to treat, and the better the prognosis. If you’re wondering how to find cancer early, read this guide to learn the recommendations for cancer screening and discuss the options available.

Why Should You Screen for Cancer?

Cancer screening is designed to detect cancer before it causes symptoms. This generally means finding cancer at an early stage when it is more treatable or, in some cases, preventing cancer altogether. Screening tests alone do not necessarily diagnose cancer. If the screening test is positive, additional testing to make a diagnosis is usually necessary.^[3]

An ideal screening test for cancer has four primary features^[3]:

• Can detect cancer or abnormal cells before someone develops symptoms
• Is able to detect cancer early, when it is easy to treat
• Treatment at an early stage will decrease the chances of death or disability from cancer
• The test has a low rate of false-positive and false-negative results

It is possible for screening tests to be negative when cancer is actually present (false negatives) or be positive when there is no cancer (false positives). An ideal screening test minimizes this risk.

What Are the Recommendations for Cancer Screening?

There are several organizations that make recommendations for cancer screening. Two of the primary organizations that make these recommendations include the United States Preventive Services Task Force and the American Cancer Society.

The United States Preventive Services Task Force (USPSTF) is a panel of primary care and prevention experts that independently reviews data on screening tests and makes recommendations regarding the age, frequency, and type of screening tests for various conditions, including cancer.^[4]

The American Cancer Society (ACS) also regularly releases recommendations for cancer screening. This organization regularly makes recommendations regarding breast, colon, lung, endometrial, cervical, and prostate cancer.^[5]

Traditional Screening Tests

There are multiple screening tests available. These tests are generally broken down into traditionally recommended tests and alternative or newer tests. The screening guidelines are generally for people at average risk. People with an increased risk for cancer due to their family history may need to be on a different schedule or have different tests.

Cervical Cancer Screening

There are two tests routinely recommended for cervical cancer screening: cytology (also known as a Papanicolaou smear or PAP smear) and Human Papillomavirus testing (HPV testing). The frequency of this testing is based on the age and risk factors for the individual patient^[6]:

• Before age 21: no screening is recommended
• Age 21-29: Pap smear every 3 years
• Age 30-65: Pap smear every 3 years or high-risk HPV testing every 5 years, or PAP smear plus HPV testing every 5 years
• Age over 65: no screening if 3 negative PAP smears or 2 negative HPV tests, or 2 negative PAP smears plus HPV tests in the previous 10 years

People who have never had precancerous cells of the cervix and have had their cervix removed do not need additional testing according to the 2024 guidelines.^[6]

Breast Cancer Screening

Mammography is the primary tool for breast cancer screening. The USPSTF recommends a mammogram every other year in average-risk women aged 40-74.^[7]

The American Cancer Society bases its recommendations on the age of the patient^[7]:

• Women aged 40-44: optional yearly mammograms
• Women aged 45-54: yearly mammograms
• Women aged 55 and over: mammogram every 1-2 years as long as the person is in good health and expected to live 10 more years

Clinical breast exams are no longer recommended for breast cancer screening by either organization.

Breast MRI may be used in women who are at higher risk for breast cancer. Most commonly, this includes people with a known genetic predisposition for breast cancer, a family history of genetic abnormality that increases breast cancer risk, a significant family history of breast cancer, or other risk factors.^[8]

Colon Cancer Screening

There are several potential tests for colon cancer screening. The USPSTF currently recommends colorectal cancer screening beginning at age 45 for average-risk individuals. Screening should continue until at least age 75 at regular intervals determined by the specific screening test used. People aged 76 to 85 may continue screening depending on their overall health status and prior screening history.^[9]

Options for colon cancer screening include^[10]:

• Fecal occult blood testing (FOBT): annually
• Fecal immunotesting (FIT): annually
• Occult blood and DNA testing: every 3 years
• Sigmoidoscopy: every 5 years
• Virtual colonoscopy (CT colonography): every 5 years
• Colonoscopy: every 10 years if negative in average-risk individuals

Colonoscopy is the gold standard test for colorectal cancer. If other screening tests are negative, a colonoscopy is recommended to look for abnormalities in the colon. A colonoscopy may detect polyps or precancerous cells in the colon, which can be removed, potentially preventing colon cancer.^[10]

Lung Cancer Screening

Lung cancer screening is recommended every year in people aged 50 to 80 years who have a 20 pack-year smoking history and have smoked within the past 15 years. People who quit smoking at least 15 years prior no longer have to be screened. The recommended screening test for lung cancer is a low-dose CT scan.^[11]

Prostate Cancer Screening

Prostate cancer screening is not currently recommended universally; however, the American Cancer Society recommends that men have the chance to discuss screening with their healthcare provider.^[12] The recommendation includes:

• Men aged 50 or higher who are at average risk for prostate cancer
• Men aged 45 who are at high risk for prostate cancer, including men of African American descent, and men with a first-degree relative with colon cancer diagnosed before age 65
• Men aged 40 who are at very high risk, such as those with more than one first-degree relative with prostate cancer diagnosed before age 65

Screening should stop when the life expectancy is less than 10 years.^[12] The current test used to screen for prostate cancer is the prostate-specific antigen or PSA.

Alternatives to Traditional Screening

New developments in cancer screening include biomarkers, which are protein markers or DNA markers shed by tumors that are primarily used to monitor treatment, such as CEA in colon cancer. PSA is an example of a biomarker used in screening. Additional biomarkers are being studied that may have a future role in cancer screening and treatment.^[13]

Another emerging test for cancer screening is known as multi-cancer detection testing. This testing evaluates DNA shed by cancer cells as they die. As of 2024, there was one test available in the US, the Galleri test.^[14] While this type of testing is not currently part of the routine screening recommendations, the Galleri test and other multi-cancer detection tests can detect more than 50 types of cancer. There are ongoing studies to determine how these tests may change the landscape of cancer screening and allow people to find more types of cancer in early stages.

Early cancer detection is crucial, as it enables cancer to be treated at an earlier stage, when the outcome is more favorable. Your healthcare provider can help you determine what screening tests are best for you.

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