Screening for Cancer

Publication Date: May 1, 2015
Last Updated: March 14, 2022

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.
6731
Clinicians should encourage biennial mammography screening in average-risk women aged 50 to 74 years.
6731

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.

6731
Clinicians should not screen average-risk women of any age for breast cancer with MRI or tomosynthesis.
6731

Cervical Cancer

Clinicians should not screen average-risk women younger than 21 years for cervical cancer.
6731
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).
6731
Clinicians should not screen average-risk women for cervical cancer with cytology more often than once every 3 years.
6731
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.
6731
Clinicians should not perform HPV testing in average-risk women younger than 30 years.
6731
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.
6731
Clinicians should not screen average-risk women of any age who have had a hysterectomy with removal of the cervix for cervical cancer.
6731
Clinicians should not perform cervical cancer screening with a bimanual pelvic examination.
6731

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.
6731
Clinicians should not screen for colorectal cancer more frequently than recommended in the 4 strategies mentioned previously.
6731
Clinicians should not conduct interval screening with fecal testing or flexible sigmoidoscopy in adults having 10-year screening colonoscopy.
6731

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.

6731

Ovarian Cancer

Clinicians should not screen average-risk women for ovarian cancer.
6731

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.
6731
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.
6731
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.
6731

Recommendation Grading

Overview

Title

Screening for Cancer

Authoring Organization

American College of Physicians

Publication Month/Year

May 1, 2015

Last Updated Month/Year

January 10, 2024

Supplemental Implementation Tools

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, nurse practitioner, physician, physician assistant

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

Methodology

Number of Source Documents
74
Literature Search Start Date
January 1, 2009
Literature Search End Date
June 30, 2014