Screening and Early Detection

Breast self-awareness is important at ALL AGES. Know how your breasts normally look and feel and notify your health care provider if you notice any changes, such as:

• A lump in the breast or under the arm
• Skin changes, including a dimple, redness or thickening
• Change in breast shape or size
• Nipple discharge
• Scaling or redness of the nipple and/or areola
• Nipple retraction or inversion
• New breast pain

Ages 25 to 39

• Clinical breast exam performed by your health care provider every three years

Ages 40 and older

• Screening mammogram every year (consider tomosynthesis, otherwise known as a 3D mammogram)
• Clinical breast exam performed by your health care provider every year, preferably before your mammogram

Begin screening at age 45, no matter which screening method you choose.

• Colonoscopy the gold standard for screening, this is the only screening that allows your health care provider to see the entire length of your colon. Normal exams repeated every 10 years.
• At-home stool-based DNA test (Cologuard) Patients that have an abnormal finding will need to have a colonoscopy for further evaluation. Patients with a normal finding will need to repeat this screening every three years.
• At-home Fecal Immunochemical Test (FIT) Patients that have an abnormal finding will need to have a colonoscopy for further evaluation. Patients with a normal finding will need to repeat this screening every year.

Lung cancer screening with a Low Dose CT scan (LDCT) is for individuals who have no signs or symptoms but are at high risk of developing lung cancer because of their smoking history and age.

You should talk to your primary care provider about LDCT screening if:

• You are between 50 and 80 years old
• You have smoked an average of one pack a day for 20 years

If you meet the criteria for a LDCT, your primary care provider, can order a lung cancer screening for you.

Talk to your primary care provider about your personal risk factors and if screening is right for you.

As a general guideline for when to begin screening, we recommend:

• Age 50 for men at average risk
• Age 45 for men at high risk — this includes African Americans and men with a first-degree relative (father, son, brother) diagnosed with prostate cancer before age 65
• Age 40 for men at even higher risk — this includes men with more than one first-degree relative (father, son, brother) diagnosed with prostate cancer before age 65

Ages 21 to 29

• Begin Pap smears at age 21
• Repeat Pap smear every three years
• Human papillomavirus (HPV) screening is not recommended for ages 21 to 29

Ages 30 to 64

• Pap smears with HPV co-testing every five years OR
• Pap smears without HPV co-testing every three years

Ages 65 and older

• Talk with your health care provider about the recommended screening interval if you have a history of abnormal Pap smears or other abnormal cervical conditions

Have a yearly preventive oral exam and dental cleaning. Notify your health care provider if:

• You notice changes in your voice or hoarseness, a lump in your neck, persistent sore throat, difficulty swallowing or moving your jaw, mouth or lip sores that do not heal, white or red patches, pain in the ear or unexplained weight loss
• You notice changes during a monthly self-screening of your mouth and tongue, especially if you use tobacco or drink alcohol
• You have been exposed to human papillomavirus (HPV), as you may be at higher risk for head and neck cancers

Beginning at age 18, self-screen monthly and know how your skin normally looks and feels. Notify your health care provider if you notice any changes, such as:

• Asymmetry One half is unlike the other half
• Borders Irregular or poorly defined border
• Color Varied from one area to another (shades of tan or brown, black, red,
  white or blue)
• Diameter Diameter greater than 6 mm
• Evolution Changing in size, color or shape

If you or a loved one is a member of the transgender community, you may need to have cancer screenings for the gender assigned at birth. It is important to be open with your health care provider to have the conversation about which screenings are best for you and at what age each screening should begin, based on your personal risk factors and family history. 

Your assigned gender at birth, surgeries, or hormones you take, can determine the types of preventative cancer screenings you should have. Screening tests help find cancer early, before you have any signs or symptoms, when it may be easier to treat.