Cancer screening by age and sex

The USPSTF finds the evidence insufficient to weigh the benefits and harms of mammography at age 75 and over. Whether to continue screening is best decided with your doctor based on your general health and life expectancy.

According to the American Cancer Society guideline (ACS, 2007), yearly MRI with mammography, usually from age 30, is recommended for women who carry a BRCA mutation, untested first-degree relatives of carriers, women with a lifetime risk of about 20 to 25% or more, and those who had chest radiotherapy between the ages of 10 and 30. A family history alone does not always mean this; your doctor or a genetic counsellor works out your level of risk.

At this age the benefit of screening is small, and the USPSTF recommends deciding based on general health, previous screening and personal preference. People who have never been screened benefit most.

According to the US Multi-Society Task Force (USMSTF, 2017), if one first-degree relative (father, mother, sister, brother or child) had bowel cancer or an advanced polyp before age 60, or two first-degree relatives at any age, colonoscopy every 5 years is recommended from age 40 or 10 years before the age at diagnosis of the youngest affected relative (whichever is earlier). In inherited syndromes such as Lynch syndrome the programme starts much earlier and is more intensive, and needs genetic counselling.

The USPSTF (2018) says the decision to have a PSA test in men aged 55 to 69 should be individual and made after discussing the benefit (a small reduction in deaths from prostate cancer) and the harms (false positives, biopsies, overdiagnosis and side effects of treatment). An update of this recommendation is in progress.

The American Cancer Society (ACS, 2010) suggests that men whose father or brother had prostate cancer before age 65 talk with their doctor about PSA from age 45, and men with several first-degree relatives diagnosed early from age 40. Men who carry a BRCA mutation should also have a personal plan.

This recommendation is not for the general public. The AASLD (2023) and EASL (2025) guidelines recommend regular surveillance with ultrasound every 6 months for patients with liver cirrhosis and some people with chronic hepatitis B (depending on age, sex, family history of liver cancer and other risk factors). If you have cirrhosis or chronic hepatitis B, talk to your doctor about this surveillance.

The USPSTF (2023) finds the evidence insufficient to weigh the benefits and harms of routine skin examination by a doctor in adults without symptoms. Show your doctor any new mole or a mole that changes in shape, colour or size.