Updated Screening Guidelines for Cancer
Comprehensive Cancer Centers always pays close attention to revisions of the annual cancer screening guidelines. This year’s screening guidelines includes new and revised recommendations for colon cancer, pancreatic cancer, breast cancer, cervical cancer and prostate cancer.
The physicians at Comprehensive urge everyone to take note of changes and adjust their personal physical evaluations accordingly. The doctors also stress that guidelines are only starting points for maintaining personal health and creating conditions for early diagnoses that lead to more successful treatment outcomes. Everyone’s health is specific to factors including personal history with cancer and other illnesses, family history, and other variables including ones determined through testing such as Cancer Genetic Counseling.
The following guidelines should serve as starting points for maintaining personal health, and should be discussed with your physicians, or oncologists, based on factors noted above regarding individual health and risk factors.
Colon Cancer Screening Guidelines
The following are age-specific recommendations for testing, accompanied by brief notes for added clarity:
- Age 21: Testing may be recommended if you have higher than average risk of colon cancer.
- Age 45-75: People 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.
For those with high risk factors for colon cancer, people who are at an increased or higher risk for colorectal cancer might need to start screening before the age of 45, and screened more often, and/or get speciﬁc tests. Screening guidelines include:
- Personal history or a strong family history of colorectal cancer or certain types of polyps.
- 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 treat a prior cancer.
Stool-Based Tests for Colon Cancer Recommendations:
- 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 Recommendations:
- Colonoscopy every 10 years for average risk; more frequent 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.
New and of Note: The age recommendation for screening has changed from 50 to 45, April 2021.
Pancreatic Cancer Screening Recommendations
Given the challenges in treating many pancreatic cancer cases, the Comprehensive team urges everyone to be mindful and follow these guidelines for screenings.
High Risk Patients: Get screenings starting at age 50 (or 10 years prior to the earliest diagnosis in the family). Those who are considered high risk should have an MRI/MRCP and/or endoscopic ultrasound annually.
Guidelines include accounting for:
- 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.
Lung Cancer Screening Guidelines
To ensure the best chances of early detection for lung cancer, Comprehensive recommends these guidelines are followed:
Age 50-80: Annual lung cancer screening with a low-dose CT scan (LDCT) if your patients meet 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.
New and of Note: The USPSTF (U.S. Preventive Services Task Force) has revised the recommended ages and pack-years for lung cancer screening. It expanded the age range to 50-80 years (previously 55 to 80 years) and reduced the pack-year history to 20 pack-years of smoking (previously 30 pack-year).
Breast Cancer Screening Guidelines
To ensure greater opportunities for early breast cancer detection, Comprehensive recommends women follow these guidelines:
- 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 should get a breast MRI and a mammogram annually, typically starting 10 years prior to earliest breast cancer diagnosis in the family. This includes:
- Have a lifetime risk of breast cancer of about 20% or greater, according to risk assessment tools that are based mainly on family history (i.e. Tyrer Cuzick).
- Have a known BRCA1 or BRCA2 gene mutation (based on having had genetic testing) or another genetic predisposition for breast cancer.
- Have a ﬁrst-degree relative (parent, brother, sister, or child) with BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves.
- Had radiation therapy to the chest when they were between the ages of 10 and 30 years.
- The American Cancer Society recommends against MRI screening for women whose lifetime risk of breast cancer is less than 15%.
New and of Note: American College of Radiology (ACR) and Society of Breast Imaging (SBI) now recommend that ALL women should be evaluated for breast cancer risk no later than age 30 (review personal and family history and complete risk-assessment).
Cervical Cancer Screening Guidelines
Comprehensive recommends women follow these screening guidelines to ensure early detection of cervical cancer
- Age 21-24: No screening needed.
- Age 25-65: Women should have an HPV test every 5 years. If HPV testing is not available, women 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.
New and of Note: There are two major diﬀerences from previous guidelines, the starting age has moved to slightly older (moved from starting at age 21 to age 25) and HPV testing recommendations have changed.
Prostate Cancer Screening Guidelines
Comprehensive recommends that men follow the guidelines below for prostate cancer screenings:
- Age 40-49: No screening.
- 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: Men aged 70+ or any man with less than 10 to 15 years life expectancy should not be screened for prostate cancer routinely.
- High Risk: Consider screening with PSA in high-risk populations and African Americans with a positive family history.
Comprehensive Cancer Centers Can Help
Physicians at Comprehensive Cancer Centers of Nevada provide a variety of options for cancer care including chemotherapy, radiation therapy, as well as clinical research for the treatment of cancer. For a complete list of clinical research studies currently being conducted at Comprehensive, click here. To schedule an appointment with the team at Comprehensive, please call 702-952-3350.
The content is this post is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.