Breast Cancer

Older women at normal risk should get a mammogram every one to two years. There may come a time when an older person no longer benefits from these tests. Screening should be personalized for older adults because benefits go down when life expectancy is limited, and harms (false positives, overdiagnosis) can increase. Talk to your healthcare provider about when it is okay to stop getting mammograms.

Cervical Cancer

A Pap test is used to screen for cancer of the cervix (the lower, narrow end of the uterus in the vagina).

Many older women do not need Pap tests. Screening may stop if ALL of the following are true:

• Over age 65
• At least 2 or 3 normal Pap tests in a row
• The last Pap test was within the past 5 years
• No abnormal Pap tests in the last 10 years
• Not at high risk of cervical cancer

Women who have had a full hysterectomy (removal of the uterus and cervix) for a non-cancer reason do not need Pap tests. If the cervix was not removed, screening should continue.

Colorectal Cancer

Older adults at average risk may have one of several types of screening:

• Colonoscopy every 10 years
• Flexible sigmoidoscopy or CT colonography every 5 years
• Fecal occult blood test (a test for blood in your stool) every year

Talk with your healthcare provider about which tests are right for you and when you can safely stop screening.

Lung Cancer

Lung cancer is the leading cause of cancer death in the U.S. Yearly screening with low-dose CT is generally recommended for:

• Long-time smokers age 55 or older
• Past smokers over age 55 who quit within the last 15 years

Screening decisions should take into account overall health, ability to function, and whether the patient could have treatment if cancer is found.

Prostate Cancer

Most experts recommend:

• Men age 55–70 discuss the risks and benefits with their doctor
• Men over 70 generally do not benefit from routine PSA screening because harms outweigh benefits

Screening options for prostate cancer include:

• Digital rectal exam, where the healthcare provider inserts a lubricated, gloved finger into the rectum to check the prostate
• A blood test called PSA (prostate-specific antigen)

PSA screening may find abnormal cells, which can lead to a prostate biopsy (removal of a small piece of prostate tissue). Biopsies carry risks and may lead to unnecessary surgeries with possible lasting side effects.

Skin Cancer

Melanoma is the most dangerous form of skin cancer. New treatments for advanced melanoma are now available.

People who may need regular skin checks include those who:

• Have had melanoma before
• Have several family members with melanoma
• Have many or unusual moles

Cancer of the Uterus (Endometrial Cancer)

All older women who have gone through menopause (periods have stopped for 12 months) should see their healthcare provider right away if they have unexpected vaginal bleeding. Bleeding or spotting can be a sign of uterine cancer.