Should You Get Cancer Screenings Earlier?

September 12, 2023

It’s an indisputable fact: Cancer screening saves lives. So you might wonder, “Does it make sense to begin screenings even earlier and have them done more often?”

“Cancer screening guidelines are established based on cancer risk. Research provides the basis for when and how often to screen to save the most lives while minimizing risks,” says University Hospitals radiologist and breast imaging specialist Donna Plecha, MD.

How Are Screening Guidelines Set?

Depending on the type of cancer screening, the goal is either to find cancer early or to prevent cancer from developing. For example, a mammogram looks for breast cancer at an early stage when it can be more easily treated or cured. A colonoscopy looks for and removes polyps hoping to prevent cancer.

Health organizations and agencies base their cancer screening recommendations on a variety of data for each type of cancer. To determine the age that most people should begin screening and how often, they look at the prevalence of a cancer type across different age groups and the speed at which it develops and spreads. Those factors establish cancer risk.

Recent Changes to Screening Guidelines

Some organizations recently lowered the age for starting certain cancer screenings. For women at average risk, the U.S. Preventive Task Force (USPTF) changed the age from 45 to 40 to start mammogram screening for breast cancer– matching the recommendation of the American College of Radiology (ACR). In another change, the American Cancer Society (ACS) lowered the age from 50 to 45 to begin colorectal cancer screening.

Why Not Screen Earlier?

Starting cancer screenings too early or having them too often can:

Increase radiation exposure in some cases
Require additional yet unnecessary procedures or treatments
Increase the risk for false positive or false negative results
Result in increased patient anxiety.

Earlier or more frequent screening increases the risk for extra tests, including unnecessary biopsies and other procedures. This applies whether it’s screening for breast, cervical, prostate or lung cancer. Each screening guideline is established based on risk.

Cancer Screening Recommendations

Below are cancer screening recommendations for people at average risk. Discuss what’s best with your doctor based on your individual and family health history.

Breast Cancer

A baseline mammogram is recommended at age 40, followed by annual mammogram screenings.

Cervical Cancer

Begin Pap smears at age 21, with repeat testing at least every three years. HPV co-testing with Pap smears should start at age 30 and women should be re-screened at least every five years.

Colorectal Cancer

Start colonoscopy screening at age 45. Follow-up screenings will vary based on results and are typically repeated within 10 years.

Prostate Cancer

A baseline prostate-specific antigen (PSA) test should be done in a man’s late 40s or early 50s.

Lung Cancer

The screening guidelines for a low-dose lung CT scan are:

Between the ages 50 – 77
A 20 pack-year smoking history (20 years of smoking a pack a day)
Current smoker, or has quit within the past 15 years
In good health – no new cough or unexplained weight loss
Willing to do the follow-up testing and treatment, if needed
Has not had a chest CT scan in the last year
Written physician order

Find more cancer screening recommendations here.

When Earlier Screening May Be Warranted

“We will screen women younger than 40 for breast cancer if they have certain risk factors,” says Dr. Plecha. “Black women are 127% more likely to die of breast cancer. There are recent studies that show that Black women and other minorities are at higher risk of being diagnosed with more aggressive breast cancer at a younger age.”

“This group of women should have earlier risk assessment and consider starting screening before age 40. But women with average risk should start screening at 40. Studies show that screening for breast cancer every year beginning at age 40 saves the most lives,” says Dr. Plecha.

“Screening guidelines are based on cancer risk. Different organizations and agencies may vary slightly in their recommendations, but the most important thing is to discuss your risk with your healthcare provider and have lifesaving screening done when it’s appropriate for you,” Dr. Plecha says.