Cancer Risk, Prevention and Screening
There is no sure way to prevent cancer, but you can help reduce your risk by making healthy choices like eating right, staying active, not smoking, and following recommended screening guidelines, which can help detect certain cancers early.
The American Cancer Society (ACS) is on a mission to free the world from cancer. As the leading cancer-fighting organization, the ACS is committed to improving the lives of people with cancer and their families through advocacy, research, and patient support, to ensure everyone has an opportunity to prevent, detect, treat, and survive cancer. Thanks in large part to decades of work, a cancer diagnosis does not come without hope, and the cancer journey is not one that is traveled alone.
Since 1980, the American Cancer Society has developed and published cancer screening guidelines to provide health care professionals and the public evidence-based information about who should be screened, when they should be screened, and which screening tests are recommended. This work is vital because many people with cancer have a better chance of survival if cancer is caught early when it might be easier to treat. In Arizona, an estimated 39,970 new cancer cases will be diagnosed this year, and 13,200 people are expected to die from the disease. Ensuring all Arizonans have access to screening is a top priority for the ACS. In 2021, the ACS and National Football League awarded nearly $150,000 to three Federally Qualified Health Centers in Arizona to increase cancer screening during the COVID-19 pandemic. Through this partnership, these health systems were able to screen 15,775 patients for colorectal cancer and 19,521 patients for cervical cancer.
Get Back on Track with Regular Cancer Screening
Last year, ACS launched a Get Screened campaign that encouraged people to schedule regular cancer screening tests in response to the delay in screening during the COVID-19 pandemic. The pandemic resulted in many elective procedures being put on hold, including cancer screenings. Delays in screening for breast, cervical, colorectal, prostate, and lung cancers could lead to cancers that are undiagnosed, untreated, and present at advanced stages, which makes them harder to treat.
In fact, a new finding led by ACS researchers show the number of women in the United States who reported having a recent (in the past year) breast cancer or cervical cancer screening dropped by 2.13 million (6%) and 4.47 million (11%) respectively in 2020 compared to 2018. The study is the first of its kind to evaluate the impact of the COVID-19 pandemic on cancer screenings nationally using population-based data. The results were published this June in the Journal of the American Medical Association (JAMA) Open Network.
The study also found that between 2018 and 2020 colonoscopies for colorectal cancer detection in the past year dropped by 16% for both men and women but was offset by an increase in stool testing of 7%. This showed the promise of at-home testing to maintain population-wide screening rates during a major healthcare disruption.
In other study findings:
• Hispanic and lower-income people experienced sharper drops in past-year breast and cervical cancer screening, reflecting newly emerging barriers and exacerbation of long-standing barriers to cancer screening.
• Asian/Pacific Islander women had a 27% drop in past-year breast cancer screening, the largest drop for any race.
• Hispanic women had a 17% drop in past-year cervical cancer screening.
• The drop in screening in the past year nearly doubled for non-high school graduates compared to college graduates. Non-high school graduates dropped by 11% for breast cancer screening and 17.7% for cervical cancer screening, compared to 6.1% and 9.5% respectively for college graduates.
ACS’ Get Screened campaign aims to increase cancer screening rates by raising awareness about the importance of recommended screenings and getting people back on track with their regular screening tests. Regular screening for cancer can help save lives. Screening increases the chance of finding certain cancers early when they might be easier to treat. And, some screening tests can prevent cancer by detecting and treating pre-cancers or cell changes before they have a chance to become cancer.
Screening is safe, effective, and accessible. Facilities that offer screening services have COVID-19 safety precautions in place. Many states have low or reduced-cost screening programs to help ensure that everyone has access, even people who don’t have insurance or a primary care doctor.
When should I get screened?
Screening tests are used to find cancer before a person has any symptoms. Here are the ACS recommendations to help guide you when you talk to your doctor about screening for certain cancers. It’s a good idea to also talk about risk factors such as lifestyle behaviors and family history that may put you or a loved one at higher risk.
Breast cancer is sometimes found after symptoms appear, but many women with breast cancer have no symptoms. This is why regular breast cancer screening is so important.
Breast cancers found during screening exams are more likely to be smaller and still confined to the breast. The size of a breast cancer and how far it has spread are some of the most important factors in predicting the prognosis (outlook) of a woman with this disease.
These guidelines are for women at average risk for breast cancer. For screening purposes, a woman is considered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, or a genetic mutation known to increase risk of breast cancer (such as in a BRCA gene) and has not had chest radiation therapy before the age of 30.
• Women between 40 and 44 have the option to start screening with a mammogram every year.
• Women 45 to 54 should get mammograms every year.
• Women 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.
All women should understand what to expect when getting a mammogram for breast cancer screening – what the test can and cannot do.
Colorectal cancer incidence declined among adults aged 50 and older in the last 15 years, and mortality rates dropped by 55% from 1970 to 2018, with a substantial fraction of these declines due to screening.
• For people at average risk for colorectal cancer, the ACS recommends starting regular screening at age 45. This can be done either with a sensitive test that looks for signs of cancer in a person’s stool (a stool-based test), or with an exam that looks at the colon and rectum (a visual exam). Talk to your health care provider about which tests might be good options for you, and to your insurance provider about your coverage. No matter which test you choose, the most important thing is to get screened.
• If you’re in good health, you should continue regular screening through age 75.
• For people ages 76 through 85, talk with your health care provider about whether continuing to get screened is right for you. When you are making your decision, consider your own preferences, overall health, and past screening history.
If you choose to be screened with a test other than colonoscopy, any abnormal test result needs to be followed up with a colonoscopy.
Cervical cancer can often be found early, and sometimes even prevented, by having regular screening tests. If detected early, cervical cancer is one of the most successfully treatable cancers.
• Cervical cancer screening should start at age 25. People under age 25 should not be tested because cervical cancer is rare in this age group.
• People between the ages of 25 and 65 should get a primary HPV (human papillomavirus) test done every 5 years. (A primary HPV test is an HPV test that is done by itself for screening. The US Food and Drug Administration has approved certain tests to be primary HPV tests.) If a primary HPV test is not available, a co-test (an HPV test with a Pap test) every 5 years or a Pap test every 3 years are still good options.
• The most important thing to remember is to get screened regularly, no matter which test you get.
• People over age 65 who have had regular cervical cancer testing in the past 10 years with normal results should not be tested for cervical cancer. Once testing is stopped, it should not be started again. Those with a history of a serious cervical pre-cancer should continue to be tested for at least 25 years after that diagnosis, even if testing goes past age 65.
• People whose cervix has been removed by surgery for reasons not related to cervical cancer or serious pre-cancer should not be tested.
• People who have been vaccinated against HPV should still follow the screening recommendations for their age groups.
Some individuals – because of their health history (HIV infection, organ transplant, DES exposure, etc.) – may need a different screening schedule for cervical cancer.
Talk to a doctor about which screening tests are right for you or visit cancer.org/get-screened for more information.
Take control of yourhealth, and help reduce your cancer risk
For most Americans who do not use tobacco, the most important cancer risk factors that can be changed are body weight, diet, and physical activity. At least 18% of all cancers diagnosed in the US are related to excess body weight, physical inactivity, excess alcohol consumption, and/or poor nutrition, and thus could be prevented.
Stay away from tobacco
There is no safe form of tobacco. If you smoke cigarettes or use other types of tobacco products, it’s best to stop. It’s also important to stay away from tobacco smoke (secondhand smoke). Both using tobacco products and being exposed to tobacco smoke can cause cancer as well as many other health problems. If you don’t use tobacco products, you can help others by encouraging the people around you to quit. Call 1-800-227-2345 for help, or visit cancer.org to learn more about quitting.
Get to and stay at a healthy weight
Being overweight or obese can increase your risk for many types of cancer. You can control your weight with the choices you make about healthy eating and exercise:
• Avoiding excessive weight gain throughout life
• Balance the calories you take in with the amount of physical activity you do
• If you are overweight, try to get to a healthy weight and stay there. Losing even a small amount of weight has health benefits and is a good place to start. Low-fat and fat-free doesn’t always mean low-calorie, so read labels and try to eat vegetables, fruits, and whole grains in the place of higher-calorie foods.
Get moving
Adults: Each week, get at least 150-300 minutes of moderate-intensity physical activity or 75-150 minutes of vigorous-intensity activity (or a combination of these). Getting to or doing more than the upper limit of 300 minutes is ideal.
Children and teens: Get at least 1 hour of moderate or vigorous intensity activity every day.
Doing some physical activity above usual activities, no matter what one’s level of activity, can have many health benefits.
Eat healthy
Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and limits or avoids red and processed meats, sugary drinks, and highly processed foods
It’s best not to drink alcohol
If you do drink, have no more than 1 drink per day for women or 2 per day for men.
A drink is 12 ounces of regular beer, 5 ounces of wine, or 1 ½ ounces of 80-proof distilled spirits.
The choices you make about diet, exercise, and other habits can affect your overall health as well as your risk for developing cancer and other serious diseases. Visit cancer.org for more information on healthy lifestyle choices.
The American Cancer Society lifesaving mission moves all of us in every community closer to a world without cancer. Whether an individual wants to understand about getting screened or their diagnosis and treatment options, about how to cope with side effects or to find transportation to their cancer care appointment, ACS is here with answers. For more cancer information, to donate, or to become a volunteer, please visit
www.cancer.org/get-screened or call the National Cancer Information Center 24/7, 365 days a year at 1-800-227-2345.
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