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  Cancer Test

 

  
Medical organization
Screening recommendations
  Breast cancer
  Mammography
AAFP Every 1 to 2 years, ages 50 to 69; counsel women ages 40 to 49 about potential risks and benefits of mammography and clinical breast examination.
ACOG Every 1 to 2 years starting at age 40, yearly after age 50
ACS Annually after age 40
AMA Every 1 to 2 years in women ages 40 to 49; annually beginning at age 50
CTFPHC Every 1 to 2 years, ages 50 to 59
NIH Data currently available do not warrant a universal recommendation for mammography for women in their 40s; each woman should decide for herself whether to undergo mammography.
USPSTF Every 1 to 2 years, ages 50 to 69
   
  Clinical Breast Examination
AAFP Every 1 to 2 years, ages 50 to 69; counsel women ages 40 to 49 about potential risks and benefits of mammography and clinical breast examination.
ACOG Yearly (or as appropriate) general health evaluation that includes examination to detect signs of premalignant or malignant conditions
ACS Every 3 years, ages 20 to 39; yearly after age 40; monthly breast self-examination beginning at age 20
AMA Continuation of clinical breast examinations in asymptomatic women older than age 40
CTFPHC Yearly, ages 50 to 69
USPSTF Insufficient evidence to recommend for or against using clinical breast examination alone; optional every 1 to 2 years, ages 50 to 69
   
  Cervical cancer
AAFP Pap test at least every 3 years to women who have ever had sexual intercourse and who have a cervix
ACOG Annual Pap test and pelvic examination beginning at age 18 or when sexually active; after 3 or more tests with normal results, Pap test may be performed less frequently on physician's advice.
ACS Pap test annually starting at age 18 or when sexually active; after 2 to 3 normal (negative) tests, continue at discretion of physician.
AGS Pap test every 3 years until age 70; in women of any age who have never had a Pap test, screening with at least 2 negative smears 1 year apart
AMA Annual Pap test and pelvic examination starting at age 18 (or when sexually active); after 3 or more normal annual Pap tests, the Pap test may be performed less frequently at the physician's discretion.
CTFPHC Pap test annually beginning at age 18 or following initiation of sexual activity; after 2 normal Pap results, perform Pap tests every 3 years to age 69.
USPSTF Pap test at least every 3 years in women who have ever had sexual intercourse and who have a cervix; discontinue regular testing after age 65 if Pap test results have been consistently normal.
   
  Colorectal cancer
AAFP No published standards or guidelines for low-risk patients
ACOG After age 50, annual FOBT (DRE should accompany pelvic examination); sigmoidoscopy every 3 to 5 years
ACS After age 50, yearly FOBT plus flexible sigmoidoscopy and DRE every 5 years or colonoscopy and DRE every 10 years or double-contrast barium enema and DRE every 5 to 10 years
AMA Annual FOBT beginning at age 50, and flexible sigmoidoscopy every 3 to 5 years beginning at age 50
AGA FOBT beginning at age 59 (frequency not specified); sigmoidoscopy every 5 years, double-contrast barium enema every 5 to 10 years or colonoscopy every 10 years.
CTFPHC Insufficient evidence to recommend using FOBT screening in the periodic health examination of individuals older than age 40; insufficient evidence to recommend sigmoidoscopy in the periodic health examination; insufficient evidence to recommend screening with colonoscopy in the general population
USPSTF After age 50, yearly FOBT and/or sigmoidoscopy (unspecified frequency for sigmoidoscopy)
   
  Prostate cancer
AAFP No published standards or guidelines for low-risk patients
ACP-ASIM Physicians should describe potential benefits and known harms of screening, diagnosis and treatment; listen to the patient's concerns, then individualize the decision to screen.
ACS and AUA Offer annual DRE and PSA screening, beginning at age 50, to men who have at least a 10-year life expectancy and to younger men at high risk.
AMA Provide information regarding the risks and potential benefits of prostate screening.
CTFPHC and USPSTF DRE and PSA tests are not recommended for the general population.
   
  Skin cancer
ACS Cancer-related checkup, including skin examination every 3 years between ages 20 and 40, and every year for anyone age 40 and older
AMA Patients should talk to their physicians about the frequency of screening for skin cancer (those at modestly increased risk should see a primary care physician annually); skin self-examination should be performed monthly.
CTFPHC Insufficient evidence to recommend for or against total-body skin examination or self-examination; counsel on avoiding sun exposure and wearing protective clothing.
USPSTF Insufficient evidence to recommend for or against routine screening for skin cancer by primary care clinicians or counseling patients to perform periodic skin examination.
   
  Testicular cancer
ACS Examine testicles as part of a cancer-related checkup.
CTFPHC Insufficient evidence to recommend routine examination of testes by physician or by patient self-examination
USPSTF Insufficient evidence to recommend for or against routine screening of asymptomatic men in the general population by physician examination or patient self-examination

DRE = digital rectal examination; FOBT = fecal occult blood testing; Pap = Papanicolaou; PSA = prostate-specific antigen.

Abbreviations for Medical Organizations: AAFP = American Academy of Family Physicians; ACOG = American College of Obstetricians and Gynecologists; ACP-ASIM = American College of Physicians-American Society of Internal Medicine; ACS = American Cancer Society; AGA = American Gastroenterological Association; AGS = American Geriatrics Society; AMA = American Medical Association; AUA = American Urological Association; CTFPHC = Canadian Task Force on Preventive Health Care; NIH = National Institutes of Health; USPSTF = U.S. Preventive Services Task Force.

 

 

 
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