Merck Manual

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Cancer Screening Recommendations*

Cancer Screening Recommendations*



Skin cancer

Physical examination

Should be part of a routine checkup

Special screening examinations or tests (such as whole body photography) not recommended

Lung cancer

Low-dose helical (spiral) computed tomography

Not recommended as part of routine evaluations

Yearly in people who smoke or who quit smoking less than 15 years ago who are between ages 55 and 74

Rectal and colon cancer

Stool examination for occult blood, immunohistochemical test, or stool DNA test

Yearly after age 45

Sigmoidoscopic or colonoscopic examination

Every 5 years beginning at age 45 (sigmoidoscopy)

Every 10 years beginning at age 45 (colonoscopy)

Computed tomography colonography

Every 5 years, starting at age 45

Prostate cancer

Blood test for prostate-specific antigen (PSA)

The benefit of screening is uncertain, so men over 50 and their doctors should discuss the possible risks and benefits of screening

African American men and men whose father or brother developed prostate cancer before age 65 should have this discussion at age 45

Cervical cancer

Papanicolaou (Pap) test and human papillomavirus (HPV) DNA test

Pap test every 3 years between ages 21 and 29

Pap test plus HPV DNA test every 5 years between ages 30 and 65 or Pap test every 3 years

No testing after age 65 if previous test results were normal and most recent test was within 5 years

Breast cancer


Women ages 40–44: Option to start annual screening

Women ages 45–54: Yearly

Women ≥ 55: Every 2 years; screening continues as long as woman is in good health and expected to live at least 10 more years

* Recommendations for screening are influenced by many factors. These screening recommendations, based primarily on those of the American Cancer Society, are for asymptomatic people with an average risk of cancer. For people with a higher risk, such as those with a strong family history of certain cancers or those who have had a previous cancer, screening may be recommended more frequently or to start at a younger age. Screening tests other than those listed here may also be recommended. Furthermore, other organizations, such as the U.S. Preventive Services Task Force, may have slightly different recommendations. A person's physician can help the person decide when to begin screening and which tests should be used.

† Magnetic resonance imaging (MRI) is recommended yearly, in addition to mammography, starting at age 30 for some women at high risk of breast cancer.