Skip to Content

Q+A: Cancer Screening

April 26, 2023

An expert provides guidance on the who, what and when regarding early detection

Debra Friedman, MD, E. Bronson Ingram Chair in Pediatric Oncology, is associate director for Community Science and Health Outcomes at Vanderbilt-Ingram Cancer Center.

Q: What should people know about cancer screening? 

A: Cancer screening is essential for detection of cancers at earlier stages when they are most treatable. Guidelines are developed by expert panels and may differ a bit from one another, but overall are similar. In addition, there are many factors which determine cancer risk and need for screening other than age alone. Some people need screening at ages earlier than the general population based on factors such as medical or family history, prior test results, lifestyle and others. Therefore, specific cancer screening recommendations should always be discussed with health care providers. 

Q: What cancers should women get screened for, and at what age?

A: Women should be screened for breast, colorectal and cervical cancer. For breast cancer, some experts suggest age 40, and others age 45, to start screening. Women who are 40-44 should have the option to start screening, and all women should start at age 45. Women at higher risk may require screening at an earlier age. For colorectal cancer, women should start screening at age 45. Women at higher risk may require screening at an earlier age. Women should begin cervical cancer screening at age 21. Dependent on their age and smoking history, women should be screened as well for lung cancer. 

Q: How about men?

A: Men should be screened for colorectal cancer starting at age 45. Men at higher risk may require screening at an earlier age. At age 45-50, men should also start a conversation with their doctors about whether they should undergo early detection testing for prostate cancer. There are those at higher risk who may require testing at an earlier age. Dependent on their age and smoking pack-year history, men should be screened as well for lung cancer. 

Q: When should smokers start getting lung scans for early detection?

A: Lung cancer screening should start at age 50 for all those current or former smokers with a history of 20 pack years of smoking or greater. Pack years are calculated as multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked: 20 pack years is equal to smoking one pack per day for 20 years, one-half pack per day for 40 years, or two packs per day for 10 years, and similar. There are some individuals who are high risk for other reasons who may require screening earlier. 

Q: When are skin checks with a dermatologist advised?

A: It is encouraged that individuals do self skin exams or partner skin exams and seek care from a dermatologist for new or changing skin findings. This includes but is not limited to lesions that are asymmetric, have irregular borders, have varied colors, are bigger than the tip of a pencil eraser, or moles that look different from others or are changing. There are some individuals at high risk who require regular exams by dermatologists. 

Q: Should people ask their dentists or their primary care providers to check for oral cancer?

A: It is recommended that everyone do mouth self-exams and if they notice a new or changing finding they should reach out to their dentist. In addition, dentists and primary care providers should be looking carefully at the time of routine exams. If a concerning lesion is seen, more specific tests can be done. There are some individuals at high risk who require regular exams by dentists.

Q: How can people schedule screenings at Vanderbilt?

A: People can contact any of their health care providers at Vanderbilt to schedule a screening, and health care providers outside of Vanderbilt can refer their patients. Vanderbilt also has resources to help patients determine if they are at higher risk than the general population for a particular cancer.