Early detection is one of the best ways to combat cancer. Catching cancer in it’s earliest stages gives you the best chances of successfully treating it. Checking for cancer (or for conditions that may lead to cancer) in people who have no symptoms is called "screening."
Your doctor's office is one of the best places to keep a regular schedule of annual check-ups and screenings, such as pap tests, mammograms, and digital rectal exams. To select an Alta Bates Summit general practitioner, choose Internal Medicine or Family Medicine from the drop-down menu on our Find A Doctor search tool.
In addition, Alta Bates Summit Medical Center offers cancer screening opportunities through the following programs:
- Carol Ann Read Breast Health Center
- Ethnic Health Institute (EHI)
- Imaging & Mammography Services - See Our Service Locations for address info.
- Markstein Cancer Education & Prevention Services
- Summit Health Center - See Our Cancer Service Locations for address info.
Screening can help doctors find and treat some types of cancer early, and generally, cancer treatment is more effective when started early. The decision to be screened, like many other medical decisions, is a personal one. The following must be considered:
- What are your medical conditions, general health, family history and age?
- What are your lifestyle habits?
- Is the screening test harmful in any way?
- What can be done if the results of the screening test are abnormal?
- What are the risks and benefits of treatment for the cancer identified in the screening test?
Cancer screening recommendations vary, so we have chosen two reputable and respected sources of information for screening recommendations and guidelines - the American Cancer Society (ACS) and the National Cancer Institute (NCI).
NCI Screening Recommendations
Screening tests are often used to check for cancers of the breast, cervix, colon, and rectum. The NCI has several fact sheets about screening tests in their Screening & Testing section of their website. Here are their recommendations for the following sites:
Breast Cancer Screening
A mammogram is the best tool doctors have to find breast cancer early. A mammogram is a picture of the breast made with x-rays. Alta Bates Summit offers digital mammograms which provide faster and more accurate imaging results than the traditional mammogram.
- The NCI recommends that women in their forties and older have mammograms every 1 to 2 years.
- Women who are at higher-than-average risk of breast cancer should talk with their health care provider about whether to have mammograms before age 40 and how often to have them.
Cervical Cancer Screening
The Pap test (sometimes called Pap smear) is used to check cells from the cervix. The doctor scrapes a sample of cells from the cervix. A lab checks the cells for cancer or changes that may lead to cancer (including changes caused by human papillomavirus, the most important risk factor for cancer of the cervix).
- Women should begin having Pap tests three years after they begin having sexual intercourse, or when they reach age 21 (whichever comes first).
- Most women should have a Pap test at least once every three years.
Colon and Rectum Cancer Screening
A number of screening tests are used to detect polyps (growths), cancer, or other problems in the colon and rectum.
- People aged 50 and older should be screened.
- People who have a higher-than-average risk of cancer of the colon or rectum should talk with their doctor about whether to have screening tests before age 50 and how often to have them.
Tests that can be used to examine the health of the colon and rectum:
- Fecal Occult Blood Test: Sometimes cancer or polyps bleed. This test can detect tiny amounts of blood in the stool.
- Sigmoidoscopy: The doctor checks inside the rectum and lower part of the colon with a lighted tube called a sigmoidoscope. The doctor can usually remove polyps through the tube.
- Colonoscopy: The doctor examines inside the rectum and entire colon using a long, lighted tube called a colonoscope. The doctor can usually remove polyps through the tube.
- Double-contrast Barium Enema: This procedure involves several x-rays of the colon and rectum. The patient is given an enema with a barium solution, and air is pumped into the rectum. The barium and air improve the x-ray images of the colon and rectum.
- Digital Rectal Exam: A rectal exam is often part of a routine physical exam. The health care provider inserts a lubricated, gloved finger into the rectum to feel for abnormal areas. A digital rectal exam allows for examination of only the lowest part of the rectum.
Other Types of Cancer
You may have heard about other tests to check for cancer in other parts of the body. At this time, we do not know whether routine screening with these other tests saves lives. The NCI is supporting research to learn more about screening for cancers of the breast, cervix, colon, lung, ovary, prostate, and skin. Go to the NCI Website to learn about the latest screening techniques available for cancer.
ACS Screening Recommendations
The following cancer screening guidelines are recommended for those people at average risk for cancer (unless otherwise specified) and without any specific symptoms. People who are at increased risk for certain cancers may need to follow a different screening schedule, such as starting at an earlier age or being screened more often. Those with symptoms that could be related to cancer should see their doctor right away.
For people aged 20 or older having periodic health exams, a cancer-related checkup should include:
- Exams for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries, as well as for some non-cancerous diseases (depending on a person's age and gender).
- Special tests for certain cancer sites are recommended as outlined below.
Breast Cancer Screening
- Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
- Clinical breast exam (CBE) should be part of a periodic health exam, about every three years for women in their 20s and 30s and every year for women 40 and over.
- Women should know how their breasts normally feel and report any breast change promptly to their health care providers. Breast self-exam (BSE) is an option for women starting in their 20s.
- Women at increased risk (for example, family history, genetic tendency, past breast cancer) should talk with their doctors about the benefits and limitations of starting mammography screening earlier, having additional tests (for example, breast ultrasound or MRI), or having more frequent exams.
Colon and Rectum Cancer Screening
Beginning at age 50, both men and women should follow 1 of these 5 testing schedules and all positive tests should be followed up with colonoscopy:
- Yearly fecal occult blood test (FOBT)* or fecal immunochemical test (FIT)
- Flexible sigmoidoscopy every 5 years
- Yearly FOBT* or FIT, plus flexible sigmoidoscopy every 5 years**
- Double-contrast barium enema every 5 years
- Colonoscopy every 10 years
*For FOBT, the take-home multiple sample method should be used. **The combination of yearly FOBT or FIT flexible sigmoidoscopy every 5 years is preferred over either of these options alone.
People should talk to their doctor about starting colorectal cancer screening earlier and/or undergoing screening more often if they have any of the following colorectal cancer risk factors:
- Personal history of colorectal cancer or adenomatous polyps
- Strong family history of colorectal cancer or polyps (cancer or polyps in a first-degree relative [parent, sibling, or child] younger than 60 or in 2 first-degree relatives of any age)
- Personal history of chronic inflammatory bowel disease
- Family history of an hereditary colorectal cancer syndrome (familial adenomatous polyposis or hereditary non-polyposis colon cancer).
Cervical Cancer Screening
All women should begin cervical cancer screening about 3 years after they begin having intercourse, but no later than when they are 21 years old. Screening should be done every year with the regular Pap test or every 2 years using the newer liquid-based Pap test.
- Beginning at age 30, women who have had 3 normal Pap test results in a row may get screened every 2 to 3 years. Another reasonable option for women over 30 is to get screened every 3 years (but not more frequently) with either the conventional or liquid-based Pap test, plus the HPV DNA test. Women who have certain risk factors such as diethylstilbestrol (DES) exposure before birth, HIV infection, or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use should continue to be screened annually.
- Women 70 years of age or older who have had 3 or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having cervical cancer screening. Women with a history of cervical cancer, DES exposure before birth, HIV infection or a weakened immune system should continue to have screening as long as they are in good health.
- Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or precancer. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above.
Endometrial (Uterine) Cancer Screening
The ACS recommends that at the time of menopause, all women should be informed about the risks and symptoms of endometrial cancer, and strongly encouraged to report any unexpected bleeding or spotting to their doctors.
- For women with, or at high risk for, hereditary non-polyposis colon cancer (HNPCC), annual screening should be offered for endometrial cancer with endometrial biopsy beginning at age 35.
Prostate Cancer Screening
Both the prostate-specific antigen (PSA) blood test and digital rectal examination (DRE) should be offered annually, beginning at age 50, to men who have at least a 10-year life expectancy.
- Men at high risk, such as African-American men and men with a strong family of one or more first-degree relatives [father, brothers] diagnosed before age 65, should begin testing at age 45.
- Men at even higher risk, due to multiple first-degree relatives affected at an early age, could begin testing at age 40. Depending on the results of this initial test, no further testing might be needed until age 45.
- Information should be provided to all men about what is known and what is uncertain about the benefits, limitations, and harms of early detection and treatment of prostate cancer so that they can make an informed decision about testing.
- Men who ask their doctor to make the decision on their behalf should be tested. Discouraging testing is not appropriate. Also, not offering testing is not appropriate.
American Cancer Society. Cancer Facts & Figures 2006. Atlanta, Ga: American Cancer Society; 2006.
Smith RA, Cokkinides V, Eyre HJ. American Cancer Society guidelines for the early detection of cancer, 2006. CA Cancer J Clin. 2006;56:11-25