Cancer screening means testing for cancer in people who feel well and have no symptoms. The point is to find cancer early, when it is smaller and easier to treat, and in some cases to find changes before they become cancer at all. Removing a precancerous polyp during a colonoscopy, or treating abnormal cervical cells found on a Pap or HPV test, can prevent cancer from ever developing.
Not every cancer has a screening test that helps, and not every test is right for everyone. At NYMD Center we follow the recommendations of the U.S. Preventive Services Task Force (USPSTF), an independent panel that weighs the evidence on benefits and harms, and we adjust for your family history and personal risk. We also tell you plainly what each test can and cannot do, so you can make a decision that fits you.
Which cancers to screen for, and when
For adults at average risk, the USPSTF recommends screening for five cancers. People with a strong family history, a known genetic mutation, prior abnormal results or other risk factors may need to start earlier or be tested more often.
Breast cancer
The USPSTF recommends screening mammography every two years for women aged 40 to 74. This 2024 update lowered the starting age from 50 to 40 for all women. Mammography finds tumors that are too small to feel. We order mammograms and arrange them at a trusted imaging center, and we follow up on any result that needs more imaging.
Cervical cancer
The USPSTF recommends cervical screening from 21 to 65: a Pap test every three years from 21 to 29, and from 30 to 65 either a Pap every three years, an HPV test every five years, or both together every five years. Screening is generally not needed after 65 for women with adequate prior normal results, or after a hysterectomy that removed the cervix for reasons other than cancer. Pap and HPV testing are done in our office by our gynecologists, who also perform follow-up testing when needed; see HPV screening and colposcopy.
Colorectal cancer
The USPSTF recommends colorectal cancer screening for adults 45 to 75, and selective screening from 76 to 85 based on health and prior testing. There are several acceptable options. Stool tests, such as a yearly fecal immunochemical test (FIT) or a stool DNA-FIT test every one to three years, can be ordered by our physicians and done at home. Colonoscopy every ten years looks at the entire colon and allows polyps to be removed during the same procedure; we arrange it with a gastroenterologist. A positive stool test must be followed by a colonoscopy.
Lung cancer
The USPSTF recommends a yearly low-dose CT scan for adults 50 to 80 who have a 20 pack-year smoking history and currently smoke or quit within the past 15 years. A pack-year is one pack a day for one year, so 20 pack-years could be a pack a day for 20 years or two packs a day for ten. Screening stops once you have been smoke-free for 15 years. We calculate your eligibility and arrange the CT.
Prostate cancer
Our urologists recommend starting PSA screening at age 50, and at 40 to 45 for men at higher risk: Black men, men whose father or brother had prostate cancer, and BRCA carriers. The USPSTF frames PSA testing as an individual decision made after discussing benefits and harms, and from age 70 screening becomes an individual decision based on health and life expectancy. Our group includes urologists, so a PSA can be interpreted and followed up in house; our prostate cancer screening page explains the process.
The honest trade-offs of screening
Screening saves lives, but it is not free of downsides, and you deserve to hear about them. According to the National Cancer Institute, possible harms include false-positive results that lead to more tests and worry, false negatives that miss a cancer, complications from follow-up procedures, and overdiagnosis: finding cancers that would never have caused problems and treating them anyway. Overdiagnosis is a particular concern with PSA testing, where the USPSTF estimates that a meaningful share of screen-detected cancers would never have caused symptoms. That is why we favor tests with the clearest benefit, stop screening when it no longer helps, and treat low-risk findings with appropriate caution, including active surveillance for some prostate cancers.
Family history and genetic risk
Your family history can change when and how you should be screened. Several close relatives with the same cancer, cancer diagnosed at a young age, or certain combinations such as breast and ovarian cancer in one family can point to an inherited risk. In those cases screening may start earlier, happen more often or use different tests, such as breast MRI. We review your family history at every annual exam and can discuss genetic testing when the pattern suggests it.
What to expect at your visit
Cancer screening is usually planned during a routine visit. We go through your age, family history, smoking history and prior results, tell you which screenings you are due for, and explain the options. Pap and HPV tests are done during a gynecologic visit, stool test kits can be ordered for home use, and mammography, colonoscopy and low-dose CT are scheduled at outside centers we work with. Each test has its own preparation, such as bowel preparation before a colonoscopy or avoiding deodorant before a mammogram, and our staff will explain it in detail. Call ahead with any questions. We track your results and let you know when your next screening is due.
When not to wait for screening
Screening is for people without symptoms. If you have symptoms such as a breast lump, blood in your stool or urine, a cough that will not go away or coughing up blood, unexplained weight loss, bleeding after menopause or a change in bowel habits, do not wait for your next scheduled screening. Make an appointment so we can evaluate the problem directly.
Questions patients ask
At what age should I start cancer screening?
For people at average risk, the USPSTF recommends cervical screening from 21, mammography every two years from 40, and colorectal screening from 45. Lung cancer screening begins at 50 for eligible current or former smokers, and prostate screening starts at 50, or at 40 to 45 for Black men, men whose father or brother had prostate cancer, and BRCA carriers. A family history or other risk factors can move these ages earlier.
Is a stool test as good as a colonoscopy?
Both are recommended options. A yearly FIT or a stool DNA-FIT test every one to three years is done at home and avoids bowel prep, but a positive result requires a colonoscopy. Colonoscopy every ten years examines the whole colon and allows polyps to be removed in the same procedure. The best test is the one you will actually complete.
Do I still need a Pap test after 65?
Most women do not, if they have had adequate screening with normal results in the years before 65 and are not at high risk for cervical cancer. Screening is also not needed after a hysterectomy that removed the cervix for reasons other than cancer or precancer. Our gynecologists can review your history and confirm whether you can stop.
What are the downsides of cancer screening?
Screening can produce false-positive results that lead to more tests, biopsies and anxiety, and false negatives that miss a cancer. It can also find cancers that would never have caused harm, which may lead to unnecessary treatment and its side effects. We weigh these trade-offs with you and recommend the tests with the clearest benefit.
Should I be screened earlier if cancer runs in my family?
Possibly. Close relatives with cancer, especially at a young age, or certain combinations of cancers in one family can raise your risk and change when and how you should be screened. We review your family history and, when the pattern suggests an inherited risk, can discuss genetic testing and earlier or more frequent screening.