Cancer Types


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Screening for Cancer
mammogram_film.jpg (3674 bytes) The life time risk of developing cancer is now 45% for men and 38% for women (see stats section).  The best strategy is prevention or avoidance (no smoking, avoid the sun etc. see prevention section). The next best thing is to get the appropriate screening tests, so that if cancer develops it can be diagnosed at the earliest possible stage.

The guidelines are constantly being modified and the best links are from the American Cancer Society (ACS) here and here, the National Cancer Institute (NCI), Memorial Sloan Kettering, and the National Comprehensive Cancer Network (NCCN) see below. In 2011 the National Lung Screen Trial (NLST) (go here) was published showing that low dose CT lung scans yearly for three years in high risk people (30 pack-year smoking history) will lower the risk of dying from lung cancer by 20%. And so in late 2011 the NCCN issued screening guidelines for high risk patients (go here) and see lung cancer screening 2013

Under Obama-Care the insurance plans must now follow the guidelines from the US Preventative Services Task Force (the A and B recommendations) (go here for a complete list of their recommendations).  Go here to download the apps for these guidelines or go to their web site here. On the healthcare.gov web site is a list of all the cancer screening and prevention tests that should be free (go here).

Also see the sections on PET Scans and Tumor Markers.

Best Links for Screening

American Cancer Society: 2009, 2010, 2011, 2012, 2013, 2015
Memorial Sloan-Kettering
NCCN (best)
NCI Screening/testing
NCI Prevention
US Task Force
and summary
AHRQ Guidelines
Breast Cancer Screening Guidelines and here
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Breast Cancer
  • Yearly mammograms starting at age 40 and continuing for as long as a woman is in good health.


  • Clinical breast exams (CBE) should be part of a periodic health exam, about every three years for women in their 20s and 30s and every year for women 40 and over.


  • Women should report any breast change promptly to their health care providers. Breast self-exam (BSE) is an option for women starting in their 20s.


  • Women at increased risk (e.g., family history, genetic tendency, past breast cancer ) should talk with their doctors about the benefits and limitations of starting mammography screening earlier, having additional tests (e.g., breast ultrasound or MRI), or having more frequent exams.
Colon and Rectal Cancer

Beginning at age 50, both men and women at average risk for developing colorectal cancer should follow one of these five testing schedules:

  • yearly fecal occult blood test (FOBT)* or fecal immunochemical test (FIT)
  • flexible sigmoidoscopy every 5 years
  • yearly FOBT* or FIT plus flexible sigmoidoscopy every 5 years**
  • double-contrast barium enema every 5 years
  • colonoscopy every 10 years

*For FOBT, the take-home multiple sample method should be used.
**The combination of yearly FOBT or FIT plus flexible sigmoidoscopy every 5 years is preferred over either of these options alone.

All positive tests should be followed up with colonoscopy.

People should begin colorectal cancer screening earlier and/or undergo screening more often if they have any of the following colorectal cancer risk factors.

  • a personal history of colorectal cancer or adenomatous polyps
  • a strong family history of colorectal cancer or polyps (cancer or polyps in a first-degree relative younger than 60 or in two first-degree relatives of any age) Note: a first degree relative is defined as a parent, sibling, or child.
  • a personal history of chronic inflammatory bowel disease
  • a family history of an hereditary colorectal cancer syndrome (familial adenomatous polyposis or hereditary non-polyposis colon cancer)
Cervical Cancer

The American Cancer Society recommends:

  • All women should begin cervical cancer screening about 3 years after they begin having vaginal intercourse, but no later than when they are 21 years old. Screening should be done every year with the regular Pap test or every 2 years using the newer liquid-based Pap test.


  • Beginning at age 30, women who have had 3 normal Pap test results in a row may get screened every 2 to 3 years with either the conventional (regular) or liquid-based Pap test. Women who have certain risk factors such as diethylstilbestrol (DES) exposure before birth, HIV infection,or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use should continue to be screened annually.


  • Another reasonable option for women over 30 is to get screened every 3 years (but not more frequently) with either the conventional or liquid-based Pap test, plus the HPV DNA test.


  • Women 70 years of age or older who have had 3 or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having cervical cancer screening. Women with a history of cervical cancer, DES exposure before birth, HIV infection or a weakened immune system should continue to have screening as long as they are in good health.


  • Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or precancer. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above.
Endometrial (Uterine) Cancer

The American Cancer Society recommends that all women should be informed about the risks and symptoms of endometrial cancer, and strongly encouraged to report any unexpected bleeding or spotting to their doctors. For women with or at high risk for hereditary nonpolyposis colon cancer (HNPCC), annual screening should be offered for endometrial cancer with endometrial biopsy beginning at age 35.

Prostate Cancer

Both the prostate-specific antigen (PSA) blood test and digital rectal examination (DRE) should be offered annually, beginning at age 50, to men who have at least a 10-year life expectancy. Men at high risk (African-American men and men with a strong family of one or more first-degree relatives (father, brothers) diagnosed at an early age) should begin testing at age 45. Men at even higher risk, due to multiple first-degree relatives affected at an early age, could begin testing at age 40. Depending on the results of this initial test, no further testing might be needed until age 45.

Information should be provided to all men about what is known and what is uncertain about the benefits and limitations of early detection and treatment of prostate cancer so that they can make an informed decision about testing.

Men who ask their doctor to make the decision on their behalf should be tested. Discouraging testing is not appropriate. Also, not offering testing is not appropriate.