Last updated December 21, 2021

Screening for Cancer

High-value care advice

Breast Cancer

Clinicians should discuss the benefits and harms of screening mammography with average-risk women aged 40 to 49 years and order biennial mammography screening if an informed woman requests it.
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Clinicians should encourage biennial mammography screening in average-risk women aged 50 to 74 years.
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Clinicians should not screen average-risk women younger than 40 years or aged 75 years or older for breast cancer or screen women of any age with a life expectancy less than 10 years.

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Clinicians should not screen average-risk women of any age for breast cancer with MRI or tomosynthesis.
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Cervical Cancer

Clinicians should not screen average-risk women younger than 21 years for cervical cancer.
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Clinicians should start screening average-risk women for cervical cancer at age 21 years once every 3 years with cytology (Papanicolaou [Pap] tests without HPV tests).
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Clinicians should not screen average-risk women for cervical cancer with cytology more often than once every 3 years.
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Clinicians may use a combination of Pap and HPV testing once every 5 years in average-risk women aged 30 years or older who prefer screening less often than every 3 years.
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Clinicians should not perform HPV testing in average-risk women younger than 30 years.
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Clinicians should stop screening average-risk women older than 65 years for cervical cancer who have had 3 consecutive negative cytology results or 2 consecutive negative cytology plus HPV test results within 10 years, with the most recent test done within 5 years.
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Clinicians should not screen average-risk women of any age who have had a hysterectomy with removal of the cervix for cervical cancer.
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Clinicians should not perform cervical cancer screening with a bimanual pelvic examination.
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Colorectal Cancer

Clinicians should encourage colorectal cancer screening by 1 of 4 strategies: high-sensitivity fecal occult blood test (FOBT) or fecal immunochemical test (FIT) (every year); sigmoidoscopy (every 5 years); combined high-sensitivity FOBT or FIT (every 3 years) plus sigmoidoscopy (every 5 years); or optical colonoscopy (every 10 years) in average-risk adults aged 50 to 75 years.
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Clinicians should not screen for colorectal cancer more frequently than recommended in the 4 strategies mentioned previously.
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Clinicians should not conduct interval screening with fecal testing or flexible sigmoidoscopy in adults having 10-year screening colonoscopy.
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Clinicians should not screen for colorectal cancer in average-risk adults younger than 50 years or older than 75 years or those with an estimated life expectancy of less than 10 years.

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Ovarian Cancer

Clinicians should not screen average-risk women for ovarian cancer.
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Prostate Cancer

Clinicians should have a 1-time discussion (more if the patient requests them) with average-risk men aged 50 to 69 years who inquire about PSA-based prostate cancer screening to inform them about the limited potential benefits and substantial harms of screening for prostate cancer using the PSA test.
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Clinicians should not screen for prostate cancer using the PSA test in average-risk men aged 50 to 69 years who have not had an informed discussion and do not express a clear preference for screening.
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Clinicians should not screen for prostate cancer using the PSA test in average-risk men younger than 50 years or older than 69 years or those with a life expectancy of less than 10 years.
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Recommendation Grading

Overview

Title

Screening for Cancer

Authoring Organization

Publication Month/Year

May 1, 2015

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

It provides high-value care screening advice for 5 common types of cancer

Target Patient Population

Asymptomatic, average-risk adults

Inclusion Criteria

Female, Male, Adolescent, Adult, Older adult

Health Care Settings

Ambulatory, Laboratory services, Outpatient, School

Intended Users

Nurse

Scope

Assessment and screening

Diseases/Conditions (MeSH)

D055088 - Early Detection of Cancer, D011315 - Preventive Medicine, D000076862 - Diagnostic Screening Programs

Keywords

cancer, cancer screening, preventive care