Cancer Screening Guidelines

Breast Cancer

Breast cancer is the second most common form of cancer in women, but if found and treated early, most patients can be cured. It is important to review your risk for breast cancer with your health care provider, as some women may benefit from a formal high-risk breast evaluation, especially those with prior family history or dense breasts.

All women should be familiar with the known benefits, limitations and potential harms linked to breast cancer screening. They also should know how their breasts normally look and feel and report any breast changes to a health care provider right away. At MUSC Health, patients have several locations to choose from to schedule their annual mammogram. The MUSC Mobile Health Unit also travels throughout the state equipped with 3D tomosynthesis mammography.

Screening: Mammogram
Age: Women over the age of 40, unless family history or risk factors require earlier screening
Frequency: Yearly

Screening: Ultrasound
May be used for women with dense breasts

Risk Factors

• Family history of breast or ovarian cancer
• Dense breasts
• Never having children or having had the first child after age 30
• Age
• Early onset of menstrual cycle (younger than 12)
• Late menopause (older than 55)
• Previous radiation to chest
• Atypical lobular hyperplasia (ALH) or lobular carcinoma in situ (LCIS)

Cervical Cancer

HPV vaccination can prevent 90% of the cancers caused by HPV, including cervical cancer.*  The human papillomavirus (HPV) vaccine is recommended for boys and girls ages 11 to 12 as part of routine adolescent immunizations. Men and women can be vaccinated up to age 45 if they have not already received the HPV vaccine. When detected early and treated, cervical cancer is usually curable. The Pap test has helped to reduce death rates by finding precancerous cells or early cancer. The HPV test improves screening by testing for the high-risk strains of HPV. 

Screening: Pap test only
Important for women
Age: 21 to 29
Frequency: Every three years

Screening: Pap & HPV test
Important for women
Age: 30 to 65
Frequency: Every five years

The frequency of screening recommendations may vary. Your doctor may screen more often if you have had an abnormal test in the past. Screening is not recommended for women without any history of cervical problems or HPV after age 65 or after a hysterectomy.

Risk Factors

• Prior history of HPV infection
• Cigarette smoking
• HIV infection or other immunosuppression such as patients taking medications for organ transplant, chemotherapy or rheumatologic conditions
• Unprotected intercourse with more than one sexual partner
• Sexual intercourse before age 18

Skin Cancer

In the United States, about 1 million Americans are diagnosed with skin cancer each year, according to the Centers for Disease Control and Prevention. The leading cause of skin cancer is ultraviolet (UV) radiation from the sun. Other sources of UV radiation include sunlamps and tanning beds.

Screening: Doctor's exam
Important for men and women
Age: All ages
Frequency: Yearly

Risk Factors

• Fair skin
• A family history of skin cancer
• Sun exposure and early childhood sunburns
• Use of sunlamps and tanning beds
• Type and quantity of moles
• New or changing mole or skin lesion

Colorectal Cancer

For men and women combined, colorectal cancer (colon cancer) is the second leading cause of cancer-related deaths in the U.S. The disease affects men and women equally, and becomes more common with increasing age. If detected and treated early, colon cancer is usually curable. For those at average risk, screening should begin starting at age 45. If you are at an increased or high risk of colorectal cancer, you might need to start screening before age 45 and/or be screened more often.

Screening: Fecal immunochemical test (FIT)
Important for men and women
Age: 45
Frequency: Every year

OR

Screening: Guaiac-based fecal occult blood test (gFOBT)
Important for men and women
Age: 45
Frequency: Every year

OR

Screening: Multi-targeted stool DNA test
Important for men and women
Age: 45
Frequency: Every three years

OR

Screening: Flexible sigmoidoscopy
Important for men and women
Age: 45
Frequency: Every five years

OR

Screening: Colonoscopy
Important for men and women
Age: 45
Frequency: Every 10 years

Risk Factors

People at high risk should talk to their doctor about beginning colonoscopy screenings at age 40 or younger. The following conditions may increase your risk:

• History of colorectal cancer or adenomatous polyps
• History of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
• Family history of colorectal cancer or polyps
• Family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
• Smoking
• A diet high in fat 

Talk to your doctor if you are experiencing any abnormal bowel movements or digestive issues. Common symptoms include:

• Chronic changes in bowel movements
• Constipation
• Diarrhea
• Bleeding
• Weight loss

Lung Cancer

Lung cancer is the leading cause of cancer-related death in both men and women in the U.S. Screening for lung cancer with low-dose computed tomography (LDCT) has been shown to decrease the risk of dying from lung cancer by detecting it at an earlier stage.

Screening: LDCT scan
Important for men and women*
Age: 50 to 80 (up to 77 for Medicare coverage)  
Frequency: Yearly

*Source: US Preventive Service Task Force

Additional Criteria

• Current smoker or former smoker having quit within the last 15 years
• Have at least 20 pack year smoking history (this means one pack a day for 20 years, two packs a day for 10 years, etc.)

Prostate Cancer

Prostate cancer ranks behind skin cancer as the most common type of cancer affecting American men. Early detection increases treatment options and saves lives. Men and their doctors should discuss available screening options and how aggressively they would address questionable findings.

Screening: Talk to your doctor about screening options
Important for men
Age: 50
Frequency: Yearly

If you are African American or have a family history of prostate cancer, talk to your doctor about your screening options at age 45.

Risk Factors

• Age: 90% of all prostate cancers are diagnosed in men over age 55
• A family history of prostate cancer
• African Americans are at an increased risk
• A diet high in fat
• A diet low in fruits, vegetables and whole grains

Oral Cancer

Alcohol and tobacco use cause at least 75 percent of head and neck cancers. Infection with cancer-causing types of human papillomavirus (HPV), especially HPV-16, is a risk factor for some types of head and neck cancers. The good news is that oral cancer is largely preventable — and if detected early — highly treatable.

Screening: Visual exam
Important for men and women
Age: 18
Frequency: Yearly

Risk Factors

• Twice as common in men as women
• Tobacco and alcohol use
• Prior history of HPV infection
• Age