Screening Mammogram. At least biennially (every two years) for women at average risk. Biennially .... Double-contrast Ba
Cancer Screening & Prevention Guidelines 2017
Appointments: 800.237.8662
Cancer prevention and screening guidelines are updated frequently. Some insurance plans will cover more frequent screening than those minimums outlined below. Please check with your physician to establish a screening strategy that is right for you.
summahealth.org/cancerscreening
Age Criteria
Screening Recommendations
Age 20 and older
Breast Self-Awareness Clinical Breast Exam
Age 20-39
Breast Health
Age 40-49
Age 50-74
Guidelines Breast self-awareness is an understanding by each woman of how her breasts normally look and feel so she can tell if there are any changes and can report them to her healthcare provider. Clinicians should periodically have such discussions with their patients. Every 1-3 years. The frequency of a clinical breast exam for an individual patient in this age group should be determined after a discussion with her healthcare provider of her individual risk factors as well as the risks and benefits of the exam.
Frequency
Order Needed
Source
Periodic
No
ACS/ACOG
1- 3 yrs.
No
ACOG
Screening Mammogram
At physician’s discretion for women with higher than average risk and age less than 40.
Discuss
Yes
USPSTF
Discuss Breast Cancer Chemoprevention
Eligible women should discuss with their healthcare provider.
Discuss
Yes
USPSTF
Clinical Breast Exam
Annually
Annually
No
ACOG
Screening Mammogram
Screening before Age 50 may be appropriate for an individual patient after a discussion of her individual risk factors as well as the risks and benefits of screening mammography. Clinicians should periodically have such discussions with their patients in this age group.
Discuss
No
USPSTF
Discuss Breast Cancer Chemoprevention
Eligible women should discuss with their healthcare provider.
Discuss
Yes
USPSTF
Clinical Breast Exam
Annually
Annually
No
ACOG
Screening Mammogram
At least biennially (every two years) for women at average risk.
Biennially
No
USPSTF
Discuss Breast Cancer Chemoprevention
Eligible women should discuss with their healthcare provider.
Discuss
Yes
USPSTF
Clinical Breast Exam
Annually
Annually
No
ACOG
Screening Mammogram
Please discuss risks & benefits with your healthcare provider.
Discuss
No
USPSTF
Age 75 and older Note: Women who have had their uterus removed (and also their cervix) for reasons not related to cervical cancer and who had no history of cervical cancer or serious pre-cancer should not be tested.
Cervical Health
Age 21-29
Pap Smear
Every 3 years, screening with cytology (Papanicolaou smear - Pap smear).
3 yrs.
Yes
ACS/ACOG/ USPSTF
Age 30-65
Pap Smear
Every 3 years, screening with cytology (Papanicolaou smear, Pap smear) alone. OR Screening with cytology (Pap smear) and HPV testing every 5 years.
3 or 5 yrs.
Yes
ASCCP/ACOG
Women over 65 who have had adequate negative testing within the past 10 years AND no history of high grade dysplasia within the past 20 years can stop cervical screening. Please discuss with your healthcare provider. CMS Requires: For initial LDCT, patient must receive written LDCT order during lung cancer screening counseling and shared decision-making visit, appropriately documented in patient’s medical records and furnished by a physician or qualified non-physician practictioner (PA, NP, CNS). Medicare coverage includes, and requires, the visit, a physician order and patient must meet CMS’s LDCT screening criteria. For subsequent screenings, the patient must receive a written order, furnished during any appropriate visit (e.g., Medicare annual wellness visit) with a physician, PA, NP or CNS.
Discuss
Yes
ACS/ACOG/ USPSTF CMS Requires: Written order must contain DOB, pack-year smoking history (number), current smoking status or years since quitting, acknowledge asymptomatic, ordering physician NPI.
CT Lung Screen (Low Dose) (Low Dose Computed Tomography LDCT)
Smoked at least one pack a day for 20 years and one additional risk: radon exposure, occupational exposure, cancer history, family history of lung cancer, COPD or pulmonary fibrosis.
Annually
Yes
NCI
Age 55-77 Prior Smoker
CT Lung Screen (Low Dose) (Low Dose Computed Tomography LDCT)
Quit smoking within the past 15 years but has a history of smoking at least 1 pack of cigarettes per day for 30 years or more OR 2 packs a day for 15 years. Asymptomatic individuals. Counsel on importance of maintaining smoking abstinence and the benefits and risks of LDCT, during a visit for counseling and shared decision making. Diagnostic follow-up of abnormal findings within 1 year. (CMS screening criteria)
Annually
Yes
CMS
Age 55-77 Current Smoker
CT Lung Screen (Low Dose) (Low Dose Computed Tomography LDCT)
History of smoking at least 1 pack of cigarettes per day for 30 years or more OR 2 packs a day for 15 years. Asymptomatic individuals. Counsel on importance of smoking cessation and the benefits and risks of LDCT, during a visit for counseling and shared decision making. Diagnostic follow-up of abnormal findings within 1 year. (CMS screening criteria)
Annually
Yes
CMS
Not recommended
USPSTF and AAFP recommend against any Prostate Specific Antigen (PSA) Blood Test based screening.
Not recommended
Yes
USPSTF/AAFP
Discuss Prostate Specific Antigen (PSA)
AUA, ACS and ACP suggest healthcare providers discuss potential risks and benefits of Prostate Specific Antigen (PSA) Blood Test based screening with men, especially those at high risk for the disease. High risk includes men with first degree family history (father, son, brother) of prostate cancer
Discuss
Yes
AUA/ACS/ACP
Age 65 and older
Pap Smear
Asymptomatic = no signs or symptoms of lung disease 1 pack = 20 cigarettes
Lung Health
Prostate Health
Age 50-54
Age 45 and older
Asymptomatic = individuals without other medical risk factors and never had a previous screening study
Colorectal Health
Symptoms = rectal bleeding, abdominal pain, unexplained changes in bowel habits (diarrhea or constipation) or unexplained weight loss
Beginning at Age 40
Colonoscopy
Every 5 years, if colorectal cancer or adenomatous polyps in any first-degree relative before age 60.
5 yrs.
Yes
ACS
Age 45
Colonoscopy
Every 10 years, asymptomatic African-Americans.
10 yrs.
Yes
ACG
Age 50
Colonoscopy
Every 10 years, asymptomatic individuals.
10 yrs.
Yes
ACS/ACG
Flexible Sigmoidoscopy*
Every 5 years
5 yrs.
Yes
ACS/ACG
Double-contrast Barium Enema*
Every 5 years
5 yrs.
Yes
ACS/ASCRS
Fecal Occult Blood Test (FOBT)*
Annually. FOBT or FIT is not recommended for 5 years after a high-quality colonoscopy.
Annually
Yes
ACS/ACG
OR Fecal Immunochemical Test (FIT)*
Annually. FOBT or FIT is not recommended for 5 years after a high-quality colonoscopy.
Annually
Yes
ACS/ACG
OR
Beginning at Age 50 or age 45 for African-Americans
* Requires follow-up colonoscopy if the selected study is abnormal. AAFP = American Academy of Family Physicians ACP = American College of Physicians ASCCP = American Society for Colposcopy and Cervical Pathology ASCRS = American Society of Colon and Rectal Surgeons
Effective 01.01.2017 ACS = American Cancer Society AUA = American Urological Association
ACG = American College of Gastroenterology CMS = Centers for Medicare and Medicaid Services
ACOG = American Congress of Obstetricians and Gynecologists NCI = National Cancer Institute USPSTF = U.S. Preventive Services Task Force CAN-16-26601/CS/EF/10-16/1,500
