American Cancer Society Guidelines for the Early Detection of Cancer

These guidelines are for the early detection of cancer in people without symptoms. Some people have a higher risk for certain cancers and may need to have tests more often, start testing at a younger age, or have additional tests. Speak with your doctor to find out how these guidelines relate to you.



Women age 40 and older should have an annual mammogram and an annual clinical breast exam by their health care professional, and should do monthly breast self-examination. Ideally, the clinical breast exam should be scheduled near to the time of and before the mammogram. Women ages 20 to 39 should have a clinical breast exam every three years and should do monthly breast self-examination.


There are two parts to the uterus. The cervix is the lower part of the uterus that extends into the upper vagina. The upper part of the uterus is called the body, and the lining layer of the body of the uterus is called the endometrium. The cancers that develop from the cervix and the endometrium are different, so the ACS guidelines address these two areas separately.


All women who are or have been sexually active or are 18 years of age or older should have an annual Pap test and pelvic exam. After three tests in a row with normal results, the Pap test may be done less often. Discuss this matter with your health care professional.


Women with or at high risk for hereditary nonpolyposis colon cancer (a genetic condition leading to an increased risk of colon cancer and endometrial cancer) should be offered an endometrial biopsy annually, starting at age 35.



Your health care professional should offer you the prostate specific antigen (PSA) blood test and the digital rectal exam every year, starting at age 50, if you have a life expectancy of at least 10 years. He or she should discuss the benefits and limitations of testing with you, so that you can make an informed decision. If you are at higher risk for prostate cancer (you are African-American or have a father or brother who was diagnosed with prostate cancer at a young age) you should begin having these tests at age 45.


Colon and Rectum

Men and women who are age 50 and older should talk with their health professionals and select one of the exam options listed below:

  • • Fecal occult blood test (FOBT) every year and flexible sigmoidoscopy every five years (the ACS prefers this option to having either FOBT or flexible sigmoidoscopy alone), or

  • • Flexible sigmoidoscopy every five years, or

  • • Fecal occult blood test every year, or

  • • Colonoscopy every 10 years, or

  • • Double-contrast barium enema every five years.

Cancer-related Checkups

A cancer-related checkup is recommended every three years for people ages 20 to 39, and every year for people 40 and older. This checkup should include health counseling (such as tips on quitting smoking) and examinations for cancers of the thyroid gland, mouth, skin, and lymph nodes in both men and women. It should also include an exam of the testicles for men and an exam of the ovaries for women.


The cancers that can be found by these tests and exams account for about half of all cancer cases in the United States. The overall five-year survival rate for people with these cancers is about 81%, but it is much worse for those individuals whose cancer is diagnosed after symptoms develop. If all of these cancers were diagnosed at a localized stage through the use of early detection tests according to ACS guidelines, the five-year survival rate would improve to about 96%.