From the Guidelines
Adults should undergo regular screenings for diabetes, breast cancer, cervical cancer, colorectal cancer, and lung cancer, as well as consider screenings for endometrial and prostate cancer, based on their individual risk factors and health status.
Recommended Screenings
- Diabetes: Screening for prediabetes and type 2 diabetes should be done in asymptomatic adults with overweight or obesity who have one or more risk factors, starting at age 35 years, or earlier if risk factors are present 1.
- Breast Cancer: Women should undergo regular screening mammography starting at age 45 years, with annual screening for women aged 45-54 years, and biennial screening or continued annual screening for women aged 55 years and older 1.
- Cervical Cancer: Cervical cancer screening should begin at age 21 years, with screening every 3 years for women aged 21-29 years, and every 5 years with both the HPV test and the Pap test (preferred) or every 3 years with the Pap test alone (acceptable) for women aged 30-65 years 1.
- Colorectal Cancer: Adults aged 45 years and older should undergo regular screening with either a high-sensitivity stool-based test or a structural (visual) examination, depending on patient preference and test availability, with screening continuing through age 75 years for adults in good health with a life expectancy of greater than 10 years 1.
- Lung Cancer: Annual screening with low-dose helical CT should be done in current or former smokers aged 55-74 years, with at least a 30-pack-year smoking history, and who have undergone a process of informed/shared decision making about the potential benefits, limitations, and harms of screening 1.
Considerations for Other Screenings
- Endometrial Cancer: Women should be informed about risks and symptoms of endometrial cancer at the time of menopause, and strongly encouraged to report any unexpected bleeding or spotting to their physicians 1.
- Prostate Cancer: Men who have at least a 10-year life expectancy should have an opportunity to make an informed decision with their health care provider about whether to be screened for prostate cancer, after receiving information about the potential benefits, risks, and uncertainties associated with prostate cancer screening 1.
Important Considerations
- Individualized Screening Decisions: Screening decisions should be individualized based on patient preferences, life expectancy, health status, and prior screening history, particularly for adults aged 76-85 years 1.
- Informed Decision Making: Patients should be fully informed about the potential benefits, limitations, and harms of screening, and should have an opportunity to make an informed decision about whether to undergo screening, particularly for prostate cancer and lung cancer 1.
From the Research
Recommended Screenings for Adults
The following screenings are recommended for adults:
- Screening for hypertension in adults 18 years or older with office blood pressure measurement 2
- Screening for anxiety disorders in adults, including pregnant and postpartum persons 3
- Screening for cancer, considering the risks of screening, life expectancy, and comorbidities 4
- Vaccinations against influenza and pneumococcal disease for adults aged 65 and older 5
- Screening for colorectal and breast cancers for adults aged 65 and older 5
Considerations for Older Adults
When screening older adults, it is essential to consider:
- Life expectancy and comorbidities when screening for cancer 4
- The balance of benefits and harms of screening for anxiety disorders in older adults, for which the evidence is currently insufficient 3
- Functional status and multiple risk factor reduction when developing screening recommendations for older adults 6
Guidelines and Recommendations
The US Preventive Services Task Force (USPSTF) provides recommendations for screenings, including:
- Screening for hypertension in adults 18 years or older with office blood pressure measurement (A recommendation) 2
- Screening for anxiety disorders in adults, including pregnant and postpartum persons (B recommendation) 3
- The USPSTF concludes that the evidence is insufficient to assess the balance of benefits and harms of screening for anxiety disorders in older adults (I statement) 3