Cancer screening intervals: U.S. age-based recommendations by cancer type

I didn’t always have a clear picture of when to get which cancer screening. At one point I had three sticky notes on the fridge—Pap test? Stool test? Mammogram?—all with question marks. It felt like the rules kept shifting. One quiet Saturday, I sat down with coffee and mapped it out by age and cancer type, and suddenly the pattern clicked. Below is the plain-English version of the grid I keep for myself, shaped by national recommendations and the trade-offs they consider. I’m sharing it here like a journal entry I wish I’d read years ago—practical, a little personal, and free of scary hype.

The age-by-age map that finally made sense to me

Here’s the way I organize it in my head. It’s built for average-risk adults (no personal history of cancer or hereditary syndromes, no inflammatory bowel disease, etc.). If you’re higher risk, the timeline can shift earlier or become more frequent—totally fair to bring that up with your clinician.

  • Breast cancer (women and many trans/nonbinary people with breast tissue): start mammography at 40, then every other year through 74. After 74, the evidence gets murkier; decide based on health status and preferences. This change to start at 40 is relatively new and aims to catch more early cancers. See the 2024 final statement: USPSTF Breast.
  • Cervical cancer (people with a cervix):
    • 21–29: Pap (cytology) every 3 years.
    • 30–65: one of three choices—primary hrHPV every 5 years, or co-testing (Pap+hrHPV) every 5 years, or Pap every 3 years. Stop after 65 if you’ve had adequate prior screening and are not high-risk. Details: USPSTF Cervical.
    • Notes I keep: no screening before 21; and if you’ve had a hysterectomy with cervix removed and no history of high-grade lesions, don’t screen.
  • Colorectal cancer (everyone, average risk): start at 45, screen regularly to 75. From 76–85, the decision is individual (health, past screening, preferences). Options (all abnormal non-colonoscopy tests should be followed by colonoscopy):
    • FIT (fecal immunochemical test) every year
    • Stool DNA-FIT every 1–3 years
    • CT colonography every 5 years
    • Flexible sigmoidoscopy every 5 years (or every 10 years + annual FIT)
    • Colonoscopy every 10 years

    Reference grid: USPSTF Colorectal.

  • Lung cancer (if you’ve smoked): annual low-dose CT for adults 50–80 with 20+ pack-years who currently smoke or quit within 15 years. Stop when it’s been 15+ years since quitting, or if health problems make curative surgery unrealistic. Details: USPSTF Lung.
  • Prostate cancer (men and many trans/nonbinary people with a prostate): ages 55–69 is a shared decision era—talk through benefits/harms of PSA-based screening and decide if it fits your values. Do not screen routinely at 70+. Summary: USPSTF Prostate.

Choosing a test without overthinking it

When I first compared the colorectal options, I fell into “paralysis by analysis.” What helped was a simple rubric:

  • If you want a home test: FIT yearly is the lightest lift; stool DNA-FIT every 1–3 years if you prefer that style. Any positive result means a diagnostic colonoscopy next.
  • If you want the longest interval: colonoscopy (every 10 years if normal) is the longest stretch, but it comes with prep, sedation, and a small risk of complications. CT colonography (every 5 years) is less invasive, but positive findings still lead to colonoscopy.
  • If you’re on the fence: I write down what matters more to me this year—convenience? sensitivity? avoiding sedation?—then pick accordingly. The USPSTF table compares intervals side by side.

Where the default is actually “don’t screen” for average risk

I used to assume “more screening = better,” but that’s not how evidence plays out. For several cancers, routine screening in average-risk, symptom-free adults isn’t recommended because harms (false positives, unnecessary procedures) outweigh benefits—or the benefit just isn’t proven.

  • Ovarian: do not screen routinely with ultrasound or CA-125. Seek care promptly for persistent bloating, abdominal/pelvic pain, early satiety, or urinary urgency—symptoms matter here.
  • Pancreatic: no routine population screening. High-risk hereditary syndromes are a separate, specialized pathway.
  • Thyroid: no routine screening in asymptomatic adults; overdiagnosis is a real issue.
  • Testicular: no routine screening or self-exam recommendation in asymptomatic adolescents/adults (know your body, but formal screening isn’t advised).
  • Bladder, Oral, Skin (visual skin exam): evidence is insufficient for routine screening in average-risk, symptom-free adults. One important exception on the prevention side: counseling fair-skinned youth and young adults on UV protection has a recommendation; I note that as a lifestyle “screening-adjacent” move.

Small notes I keep on the margin of my calendar

These footnotes save me from confusion each year:

  • Breast density: even with dense breasts, starting at 40 and going every other year still applies under the USPSTF. Whether to add ultrasound or MRI is an unsettled question; talk through local practice and personal risk.
  • Cervical stop age: stopping after 65 only makes sense if you’ve had adequate prior screening. If records are spotty, it’s worth double-checking before stopping.
  • After hysterectomy: if the cervix was removed and there’s no history of high-grade cervical lesions or cervical cancer, no more Pap/HPV screening.
  • Family history & genetics: a first-degree relative with early colorectal cancer, BRCA1/2, Lynch syndrome, or other hereditary risks can shift the start age and interval. When in doubt, I write down my family tree and ask for a referral for formal risk assessment.
  • Lung screening exit: I put a “15-year quit” anniversary in my phone; beyond that, the default is to stop LDCT if otherwise healthy.
  • Prostate decisions: I block an annual “values check-in” between 55–69 to revisit PSA pros/cons, especially if other health issues change.

My simple “screening year” routine

I like routines. Every January, I sketch the year using this low-stress loop:

  • Step 1—Inventory: I list last dates for Pap/HPV, mammogram, stool test/colonoscopy, LDCT (if eligible), and whether I’m in the 55–69 window for PSA discussion.
  • Step 2—Plan: I book what’s due in the first half of the year and set reminders for the rest. For stool tests, I request the kit early so it doesn’t get buried under life.
  • Step 3—Confirm: I skim the specific guideline page the week before (links above) to see if intervals changed, then have a short “what’s right for me this year?” chat with my clinician.

Signals that tell me to slow down and double-check

Screening is for people who feel well. Symptoms are a different lane. I keep this list to avoid hand-waving away things that deserve attention:

  • Breast: a new lump, nipple inversion/discharge, or skin changes—get it checked promptly, regardless of last mammogram.
  • Cervix/uterus: postmenopausal bleeding is a must-evaluate signal; younger people with abnormal bleeding patterns also deserve a look.
  • Colon/rectum: rectal bleeding, iron-deficiency anemia, persistent change in bowel habits, unexplained weight loss—don’t wait for your next screening interval.
  • Lung: cough that won’t quit, coughing blood, unexplained chest pain or weight loss—see someone, even if your LDCT is “not yet due.”
  • Prostate/urinary: new urinary obstruction, bone pain, or blood in urine—bring it up; screening and diagnostic evaluation are different pathways.

How I reconcile different organizations without losing my mind

Honestly, this part used to stress me out. One society favors earlier or annual mammograms; another is comfortable with biennial intervals. My peace-keeping approach is:

  • Pick one anchor for the baseline (I use USPSTF for screening intervals because they grade population benefits and harms).
  • Layer in preferences and risk (family history, health status, anxiety about false positives, access to follow-up) to justify the tempo I can live with.
  • Revisit once a year. If a major update happens (like breast starting at 40), I adjust.

Age-based quick reference you can copy into your notes

  • 20s: Start Pap every 3 years at 21. No routine breast imaging yet for average risk. No prostate/colorectal/lung screening unless risk dictates.
  • 30–39: Continue cervical screening (Pap q3 or hrHPV q5 or co-test q5). Otherwise, most cancer screening is still risk-based only.
  • 40–44: Mammogram every other year begins at 40. Cervical continues. Consider individual prostate conversations only if risk is unusual.
  • 45–49: Colorectal screening starts (choose FIT yearly, stool DNA-FIT q1–3, CT colonography q5, sigmoidoscopy q5 or q10+annual FIT, or colonoscopy q10). Keep mammogram biennial; keep cervical per plan.
  • 50–54: Continue biennial mammogram and colorectal. If you have 20+ pack-years and smoke/quit <15y, begin annual LDCT lung screening.
  • 55–69: Add a shared decision chat on PSA (some men will screen, some won’t). Keep colorectal on schedule; mammogram every other year; LDCT annually if eligible.
  • 70–74: Mammogram every other year, colorectal per plan; no routine prostate screening at 70+. Lung LDCT continues if still eligible.
  • 75–85: Mammogram stops at 74 by default under USPSTF; beyond that is case-by-case. Colorectal 76–85 is individualized (health, prior screening). Lung LDCT continues only if you still meet criteria (and stops once 15 years smoke-free).

What I’m keeping and what I’m letting go

I’m keeping a short list, not a binder. For me, that’s:

  • Keep: the five anchors (breast, cervical, colorectal, lung-if-eligible, prostate-by-choice).
  • Keep: a bias toward asking when my situation doesn’t fit the textbook (family history, dense breasts, prior polyps, hormone therapy, gender-affirming care considerations).
  • Let go: the idea that more screening is always better. For ovarian, pancreatic, thyroid, testicular, bladder, and routine skin exams, I accept the “no/insufficient” stance for average risk—and stay symptom-aware instead.

When in doubt, I open the exact USPSTF page for that cancer, skim the “Clinician Summary,” and write down the interval that fits me this year. Here are those pages again for easy retrieval: Breast, Colorectal, Cervical, Lung, Prostate.

FAQ

1) Do I need a mammogram every year or every other year?
Answer: For average-risk adults, USPSTF recommends every other year starting at 40 through 74. Some groups favor annual screening; choosing biennial versus annual can be a preference-and-risk discussion with your clinician. See: USPSTF Breast.

2) Which colorectal test should I pick at 45?
Answer: The “best” test is the one you’ll complete and follow up as needed. Stool tests (like FIT) are annual, stool DNA-FIT is every 1–3 years, CT colonography is every 5 years, and colonoscopy is every 10 years when normal. Abnormal non-colonoscopy tests require a colonoscopy next. Source: USPSTF Colorectal.

3) I quit smoking 12 years ago and have 25 pack-years. Should I get lung screening?
Answer: Yes—annual LDCT applies if you’re 50–80 with 20+ pack-years and quit within the last 15 years. You’d stop once you pass the 15-year mark since quitting (or if health limits benefit). See: USPSTF Lung.

4) I’m 66 with regular negative Pap/HPV results. Can I stop cervical screening?
Answer: Often yes—USPSTF recommends stopping after 65 if you’ve had adequate prior screening and are not otherwise high-risk. It’s worth confirming your records before stopping. Details: USPSTF Cervical.

5) Should I get a PSA test “just to be safe” at 72?
Answer: USPSTF recommends against routine PSA screening at 70+ because harms outweigh benefits on average. If you’re 55–69, it’s a shared decision; at 70+, routine screening is not advised. See: USPSTF Prostate.

Sources & References

This blog is a personal journal and for general information only. It is not a substitute for professional medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Always seek the advice of a licensed clinician for questions about your health. If you may be experiencing an emergency, call your local emergency number immediately (e.g., 911 [US], 119).