Cancer Screening Navigation
Adults 18 and older can plan screening or review an abnormal result. A provider checks age, cervix, smoking, and history. A lump, bleeding, or lasting cough needs diagnosis. Mammograms, cervical tests, stool tests, colonoscopy, and low-dose lung CT are outside. Any blood testing needs a separate indication; confirm outside testing access and cost. A referral is not acceptance.
Symptoms and questions to discuss
- No symptom, and a screen may be due
- Smoking history with a lung-screen question
- Abnormal mammogram, cervical test, stool test, or lung scan
- New lump, bleeding, stool blood, or lasting cough
- Missing report from an outside center
What we check
- Age, cervix, pack-years, and the year tobacco stopped
- Past results, hysterectomy, chest radiation, prior cancer, and high-risk biopsies
- Symptoms that move the visit from screening to diagnosis
- Family patterns outside the average-risk schedule
- Which provider reads the next outside report
Treatment options by class
Your provider reviews appropriate options and follow-up based on your assessment.
- An average-risk schedule set from age and history
- Help choosing an outside colon test, which is not done here
- A discussion about stopping tobacco, with no program or medicine named
- A diagnostic request after an abnormal screen
When we refer
Abnormal screens and possible cancer symptoms go to outside imaging, gynecology, gastroenterology, or lung care. High-risk genes and other exclusions leave this schedule. This program does not treat cancer or do these tests. A referral request is not acceptance.
Average-risk intervals and exclusions
Breast every 2 years, ages 40-74, for women and other adults assigned female at birth, including transgender men and nonbinary persons, at average risk. Included: a parent, sibling, or child with breast cancer, or dense breasts. Excluded: BRCA or another high-risk gene, high-dose chest radiation when young, prior breast cancer, or a high-risk biopsy. Insufficient evidence after 74, and for ultrasound or MRI after a negative mammogram only for density. Cervix if present, including after HPV vaccination: cytology every 3 years at 21-29; at 30-65, cytology every 3 years, high-risk HPV every 5 years, or both every 5 years. Not under 21; not after cervix removal without high-grade precancer or cervical cancer; not after 65 with adequate past screening and no high risk. Different plan: high-grade precancer, cervical cancer, diethylstilbestrol before birth, or a compromised immune system such as HIV. Colon at 45-49 and 50-75 only with no symptoms and no prior colorectal cancer, adenomatous polyps, inflammatory bowel disease, Lynch syndrome, or familial adenomatous polyposis. Ages 76-85 are selective, by health, past screening, and preferences. Outside: yearly high-sensitivity guaiac or FIT; stool DNA-FIT every 1-3 years; CT colonography every 5 years; flexible sigmoidoscopy every 5 years, or every 10 years plus yearly FIT; colonoscopy every 10 years. Lung: yearly low-dose CT, ages 50-80, at least 20 pack-years, smoking now or quit within 15 years, after discussing benefits, limits, and harms. A pack-year is about one pack a day for a year. Stop after 15 smoke-free years, or if health limits life expectancy or the ability to have lung surgery.
What this visit does not do
The visit makes the plan and the referral. Imaging, stool tests, colonoscopy, and cervical lab work are outside. Blood tests do not replace these cancer screens. Confirm outside availability and cost. No cessation program, result time, or partner is confirmed.
Who reads the report
Confirm who receives and explains each outside report and arranges reassessment. Screening is not diagnosis: abnormal does not prove cancer; normal can miss it. A positive stool screen requires colonoscopy, not a repeat stool test. Other abnormal screens may need imaging or biopsy. A missing report is not normal; contact the ordering provider rather than waiting silently.
When not to wait
A new lump, bleeding, stool blood, or lasting cough needs diagnosis now. Call 911 for heavy bleeding, vomiting blood, sudden breathlessness, chest pain, severe pain, sudden weakness, confusion, or trouble speaking. In cancer treatment, or with low white cells, fever of 100.4°F (38°C) or higher is emergency care. Do not delay emergency care while seeking permission or taking a fever-lowering medicine.
Frequently asked questions
Is a screening mammogram a diagnosis?
No. An abnormal result needs diagnostic assessment and, when indicated, further imaging or biopsy rather than another routine screen.
Does HPV vaccination replace cervical screening?
No, if a cervix is present and age fits. The test is outside.
Is colonoscopy the only colon option?
No. Stool tests, CT colonography, and sigmoidoscopy are outside options too.
Under 20 pack-years, is a lung CT due?
Not as screening. Do not wait on a cough or other symptom.
What if no report arrives?
Missing is not normal. Ask for a record request. No date is set.
Sources
- Breast Cancer: Screening — U.S. Preventive Services Task Force
- Cervical Cancer: Screening — U.S. Preventive Services Task Force
- Colorectal Cancer: Screening — U.S. Preventive Services Task Force
- Lung Cancer: Screening — U.S. Preventive Services Task Force
- Cancer Screening Overview (PDQ) – Patient Version — National Cancer Institute
- Watch Out for Fever — Centers for Disease Control and Prevention
Content approved by Viva Centers