Cancer screening guidelines play a crucial role in finding and preventing cancer early. These guidelines help doctors and patients know the best ways to check for cancer. Experts create these guidelines by looking at the newest research to suggest the best tests. They consider things like age, gender, and how likely someone is to get cancer. By following these guidelines, people have a better chance of finding cancer when it’s easier to treat, which can save lives. It’s about giving people the knowledge and tools they need to take charge of their health.

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COLON

Age 45-75: Patients at average risk (are in good health and with a life expectancy of more than 10 years) should continue regular colorectal cancer screenings.

Age 76-85: The decision to be screened should be based on patient preference, life expectancy, overall health, and prior screening history.

Age 86 and over: Should no longer get colorectal cancer screening.

High Risk: Patients who are at an increased or high risk for colorectal cancer might need to start screening before the age of 45, be screened more often, and/or get specific tests. This includes:

• A personal history or a strong family history of colorectal cancer or certain types of polyps.
• A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease).
• A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome (also known as hereditary non-polyposis colon cancer or HNPCC).
• A personal history of radiation to the abdomen (belly) or pelvic area to re-treat a prior cancer.

Stool-based Tests

• Highly sensitive fecal immunochemical test (FIT) every year.
• Highly sensitive guaiac-based fecal occult blood test (gFOBT) every year.
• Multi-targeted stool DNA test (mt-sDNA) every 3 years.

Visual (structural) Exams of the Colon & Rectum

• Colonoscopy every 10 years for average risk; more frequently based on personal and family history or if pathology identified.
• CT colonography (virtual colonoscopy) every 5 years; more frequently if pathology identified.
• Flexible sigmoidoscopy (FSIG) every 5 years; more frequently if pathology identified.

LUNG CANCER

Age 50-80: Annual lung cancer screening with a low-dose CT scan (LDCT) if your patient meets the following conditions:

• Fairly good health.
• A current or former smoker (within the past 15 years).
• Have at least a 20 pack-year smoking history.

BREAST CANCER

Age 40-74: Start screening with mammogram annually.

Age 75 and over: Should continue with mammograms as long as their overall health is good, and they have a life expectancy of 10 or more years.

High Risk: Women who are high risk for breast cancer are advised to have MRI surveillance starting at age 25 to 30. These women are also encouraged to begin annual mammograms at age 25 to 40, depending on their individual risk type. The high-risk category includes those with:

• An increased risk of breast cancer as a result of genetics, including those with BRCA1 mutations.
• A calculated lifetime risk of 20% or more.
• Exposure to chest radiation at a young age.

Additionally, women diagnosed with breast cancer prior to the age of 50 or those who have a personal history of breast cancer and dense breasts should have annual supplemental breast MRIs. Women who are high risk but are unable to undergo MRI screenings should consider contrast-enhanced mammography.

What’s New? The United States Preventive Services Task Force has updated their guidance on MRI surveillance for those in the high-risk category.

CERVICAL CANCER

Age 25-65: Patients should have an HPV test every 5 years. If HPV testing is not available, patients can get screened with an HPV/PAP co-test every 5 years, or a PAP test every three years.

Age 65 and older: No screening needed if a series of prior tests were normal.

PROSTATE CANCER

Start discussions about screening options:

Average Risk:

Age 50-69: Consider screening with a PSA for average risk patients. The decision to screen with PSA should be based on patient preference, family history and current health.

Age 70: Patients 70+ or with a life expectancy less than 10 to 15 years should not routinely be screened for prostate cancer.

High Risk:

Age 45: Consider screening with PSA in high-risk populations including Black patients and those with a positive family history.

Age 40: This includes patients who have more than one first-degree relative (father or brother) who had prostate cancer at an early age (younger than age 65) or patients with a genetic predisposition for prostate cancer (ex. BRCA1/2 positive, or other genes).

PANCREATIC CANCER

High Risk: Patients, starting at age 50 (or 10 years prior to the earliest diagnosis in the family), who are considered high risk should have an MRI/MRCP and/or endoscopic ultrasound annually. This includes:

• Certain gene mutations such as ATM, BRCA1, BRCA2, Lynch Syndrome, and others.
• Family history of pancreatic cancer in two or more first-degree relatives.
• Family history of pancreatic cancer in three or more first and/or second-degree relatives.

What’s New? The American Society for Gastrointestinal Endoscopy recommends all patients with the BRCA1 or BRCA2 genetic variant undergo screening, regardless of prior family history.

Preventative screening guidelines are advised for individuals based on their sex assigned at birth. If a person has had surgical reassignment, they should discuss screening guidelines with their doctor.

Genetic Risk Assessment

Minnesota Oncology’s Genetic Counselors can see high risk patients via telehealth or in-person to assess their age to start screening and recommended frequency based on personal history, family history, and previous genetic testing.