When to Start Cancer Screenings
When to Start Cancer Screenings and What to Know
Writer: Jordan Stachel
Cancer screening is a vital part of preventive healthcare, helping detect cancer early, often before symptoms appear. Early detection can significantly improve treatment outcomes and even save lives. But knowing when to start cancer screenings and which tests to get can feel overwhelming. Guidelines vary depending on your age, sex, family history, and other risk factors. In this article, current cancer screening guidelines are discussed, and major recommendations from authoritative sources are highlighted. This can help you better understand how to take charge of your health.
What Are Cancer Screening Guidelines?
Cancer screening guidelines are evidence-based recommendations that outline when and how often people should be screened for specific types of cancer. These guidelines are developed by expert panels who evaluate the latest research to balance the benefits of early detection against the risks of overdiagnosis and unnecessary treatment.
Two leading authorities that shape these guidelines are the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS). The USPSTF is an independent panel of experts in disease prevention and evidence-based medicine.[1] The ACS uses a rigorous process of evaluating clinical data to update its guidelines regularly.[2]
Why Early Cancer Detection Matters
Detecting cancer early can significantly improve outcomes. For many cancers, early-stage detection increases the chance of successful treatment and long-term survival. For example, the 5-year relative survival rate for localized breast cancer is 91.7%—compared to 32.6% once the cancer has spread to distant parts of the body.[3]
Early detection also allows for less aggressive treatment, improves quality of life, and reduces overall healthcare costs. Screening programs are a cornerstone of preventive health, targeting asymptomatic individuals to catch disease before it progresses.[4]
When to Start: Age-Specific Cancer Screening Recommendations
1. Breast Cancer: Mammograms
Women aged 40 to 74 should undergo mammography every 2 years, depending on individual risk and shared decision-making with healthcare providers.[5]
The USPSTF recently updated its guidance to recommend biennial screening starting at age 40, rather than 50, due to improved detection and decreasing racial disparities.[1]
2. Colorectal Cancer: Colonoscopy and Stool Tests
Screening is recommended for adults aged 45 to 75 using colonoscopy every 10 years, or stool-based tests like fecal immunochemical test (FIT) or guaiac fecal occult blood test (gFOBT) annually.[6]
Those with a family history or genetic predispositions may require earlier and more frequent screening.
3. Cervical Cancer: Pap Smear and Human Papillomavirus (HPV) Testing
People with a cervix aged 21 to 29 should get a Pap test every 3 years.[7]
From ages 25 to 65, the options include:[7]
- Pap test every 3 years
- High-risk HPV test every 5 years
- Cotesting (Pap + HPV) every 5 years
4. Prostate Cancer: Prostate-Specific Antigen (PSA) Testing
Men aged 55 to 69 should discuss PSA screening with a healthcare provider.
Routine screening is not universally recommended due to risks of false positives and overtreatment, but may be beneficial for those at higher risk, such as African American men or those with a family history.[8]
5. Lung Cancer: Low-Dose CT
Annual screening with low-dose CT is recommended for adults aged 50 to 80 with a 20 pack-year smoking history who currently smoke or who quit within the past 15 years.[9]
Cancer Screening by Risk Group
Most guidelines are designed for individuals at average risk of developing a condition. But if you have genetic mutations (like the BRCA1/2 gene), a strong family history of cancer, or a personal history of certain illnesses, you may be considered high risk.
High-risk individuals may need earlier and more frequent screenings or additional tests not recommended for the general population. A cancer risk assessment, often conducted by a healthcare provider or genetic counselor, can help determine the right approach.[10]
Comparing Guidelines: USPSTF vs ACS
There can be subtle differences between organizations’ guidelines. For example:[1,2]
| Cancer type | USPSTF start age | ACS start age |
|---|---|---|
| Breast | 40 (biennial) | 45 (annual, optional at 40) |
| Colorectal | 45 | 45 |
| Cervical | 21 | 25 |
| Prostate | 55 (shared decision) | 50 (high risk: 45) |
| Lung | 50 (for high-risk smokers) | 50 (high-risk smokers) |
These discrepancies reflect differing interpretations of available evidence. It’s important to consult with your healthcare provider to tailor guidelines to your personal health status.
Emerging Innovations in Cancer Screening
While traditional methods, such as mammography and colonoscopy, remain the gold standards, newer technologies are transforming the landscape of cancer detection.
One promising development is the multi-cancer early detection (MCED) test, such as Galleri®, which uses a single blood sample to detect signals from over 50 types of cancer.[11] Although not yet standardized, these tests represent a potential breakthrough for detecting cancers that current screening methods lack.
Additionally, AI-based image analysis and personalized genetic testing are on the rise, with the potential to improve the accuracy and scope of early cancer detection.[12]
What to Expect from Common Screenings
Understanding the process of screenings can help reduce anxiety. Here’s what’s involved:[4]
- Mammography: A quick, low-dose X-ray of the breast. Discomfort is usually brief and minimal.
- Colonoscopy: A long, flexible tube is used to examine the colon. Bowel prep the night before is typically the most uncomfortable part.
- Pap/HPV test: A swab collects cells from the cervix. Mild cramping may occur.
- Low-dose CT: A noninvasive scan that takes just minutes.
- PSA test: A simple blood test.
Discussing risks, benefits, and logistics with your healthcare provider helps ensure you are fully informed and comfortable.
FAQs About Cancer Screening Guidelines
What are the new guidelines for cancer screening?
The USPSTF now recommends starting breast cancer screening at age 40 instead of 50. Colorectal screening is recommended to begin at age 45. These changes aim to improve early detection and reduce disparities.[1,6]
What are three common cancer screening tests?
- Mammogram: breast cancer
- Colonoscopy or FIT: colorectal cancer
- Pap smear with HPV test: cervical cancer
What is the basic screening for cancer?
Basic screenings refer to population-level tests for common cancers (for example, breast, colorectal, and cervical) that follow standardized guidelines.[4]
Who decides cancer screening guidelines?
Guidelines are created by expert panels like the USPSTF, ACS, and the Centers for Disease Control and Prevention (CDC), based on evidence from clinical trials, observational studies, and public health data.[1,2,4]
What is the latest cancer screening test?
The MCED blood test is one of the newest innovations. Though not widely adopted, it holds promise for detecting multiple cancers in asymptomatic individuals.[11]
Take Action: Your Next Step
Preventive screening is a key part of lifelong health. If you’re unsure of where to start, talk to your healthcare provider or use online tools to assess your risk. Everlywell offers a range of at-home lab tests to support your wellness journey, from hormone and vitamin panels to thyroid and cholesterol testing.
Explore Everlywell's health tests and take a proactive step in your preventive care today.
References
- US Preventive Services Task Force. A & B recommendations. Accessed July 14, 2025. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations
- American Cancer Society. American Cancer Society guidelines for the early detection of cancer. Last reviewed November 1, 2023. Accessed July 14, 2025. https://www.cancer.org/cancer/screening/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html
- National Cancer Institute. Cancer stat facts: female breast cancer. SEER. Accessed July 14, 2025. https://seer.cancer.gov/statfacts/html/breast.html
- Centers for Disease Control and Prevention. Cancer screening tests. Updated January 16, 2025. Accessed July 14, 2025. https://www.cdc.gov/cancer/prevention/screening.html
- Wilson S. AAFP backs updated USPSTF breast cancer screening guidance. American Academy of Family Physicians. Published June 13, 2024. Accessed July 14, 2025. https://www.aafp.org/news/health-of-the-public/2024-breast-cancer-screening-update.html
- US Preventive Services Task Force. Colorectal cancer: screening. Published May 18, 2021. Accessed July 14, 2025. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
- National Cancer Institute. Cervical cancer screening. Updated February 13, 2025. Accessed July 14, 2025. https://www.cancer.gov/types/cervical/screening
- US Preventive Services Task Force. Prostate cancer: screening. Updated December 21, 2023. Accessed July 14, 2025. https://www.uspreventiveservicestaskforce.org/uspstf/draft-update-summary/prostate-cancer-screening-adults
- US Preventive Services Task Force. Lung cancer: screening. Published March 9, 2021. Accessed July 14, 2025. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening
- National Cancer Institute. Breast cancer risk assessment tool: online calculator (The Gail Model). Accessed July 14, 2025. https://bcrisktool.cancer.gov/
- GRAIL. Galleri® test. Accessed July 14, 2025. https://www.galleri.com/
- National Institutes of Health. NIH findings shed light on risks and benefits of integrating AI into medical decision-making. Published July 23, 2024. Accessed July 14, 2025. https://www.nih.gov/news-events/news-releases/nih-findings-shed-light-risks-benefits-integrating-ai-into-medical-decision-making