Cancer Screening in Women Over Age 50

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OncoLink Team
Abramson Cancer Center of the University of Pennsylvania
Last Modified: March 23, 2012

Cancer screening tests are designed to find cancer or pre-cancerous areas before there are any symptoms and, generally, when treatments are most successful. Various organizations have developed guidelines for cancer screening for women. While these guidelines vary slightly between different organizations, they cover the same basic screening tests for breast, cervical and colorectal cancers. Learn more about screening tests. In addition, during routine health exams (at any age) your healthcare provider may also evaluate for cancers of the skin, mouth, thyroid and ovaries. Not all screening tests are right for everyone and your personal and family health history can affect which tests are right for you and at what age you begin them, so be sure to discuss this with your healthcare provider.

The American Cancer Society (ACS) recommends these screening guidelines for women over the age of 50:

Breast cancer

  • Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
  • Clinical breast exam (CBE) every year for women 40 and over.
  • In addition to mammograms and CBE, a monthly breast self-exam (BSE) is a good way to monitor breast health. Women should know how their breasts normally look and feel and report any change promptly to their health care provider.

The ACS recommends that some women - because of their family history, a genetic tendency, or certain other factors - be screened with MRI in addition to mammograms. The number of women who fall into this category is small- less than 2% of all US women. Talk with your doctor about your personal history and whether you should have additional tests at an earlier age. For more information, see the ACS document, Breast Cancer: Early Detection.

Cervical cancer

  • Screening should be done every year with the regular Pap test or every 2 years using the newer liquid-based Pap test.
  • Women older than 30, who have had 3 normal Pap test results in a row, may get screened every 3 years with either the conventional or liquid-based Pap test, plus the human papilloma virus (HPV) test.
  • Women 70 years of age or older who have had 3 or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having Pap tests.
  • Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having Pap tests, unless the surgery was done as a treatment for cervical cancer or pre-cancer. Women who have had a hysterectomy without removal of the cervix should continue to have Pap tests.

Some women, because of their history, may need to have a different screening schedule for cervical cancer. Please see the ACS document Cervical Cancer: Prevention and Early Detection for more information.

Endometrial (uterine) cancer screening

The ACS recommends that at the time of menopause, all women should be informed about the risks and symptoms of endometrial cancer. Women should report any unexpected bleeding or spotting to their doctors. Some women, because of their history, may need to consider having a yearly endometrial biopsy. Please talk with your doctor about your history.

Skin cancer screening

Skin cancer is the most common cancer diagnosed today and is one of the easiest to prevent or detect early. Remember that people of all skin tones can, and do, get skin cancer. Start by practicing sun safety, including using a broad spectrum sunscreen (protects against UVA & UVB rays) every day, avoiding peak sun times (10am-4pm, when the rays are strongest) and wearing protective clothing such as hats, sunglasses and long sleeved shirts.

Examine your skin regularly so you become familiar with any moles or birthmarks. If a mole has changed in any way, including a change in size, shape, or color, has developed scaliness, bleeding, or oozing, or has become itchy or painful, or you develop a sore that will not heal, you should have a healthcare provider examine the area. If you have many moles, it may be helpful to make note of moles using pictures or a mole map. SkinCancerNet has a helpful guide to performing a skin exam.

Learn more about the types of skin cancer on OncoLink and the American Academy of Dermatology's SkinCancerNet and the Skin Cancer Foundation.

Colorectal Cancer Screening

Most men and women, over the age of 50 should undergo routine screening for colon and rectal cancer. Testing may be appropriate for younger people with a high risk personal or family health history.

Options for screening for colon cancer can be divided into those that screen for both cancer and polyps and those that screen just for cancer. Tests that screen for cancer and polyps include flexible sigmoidoscopy, colonoscopy, double-contrast barium enema or CT colonography (virtual colonoscopy). Tests that screen mainly for cancer include stool testing for blood or stool DNA testing. Learn more about the CRC screening options.

The "preferred screening" of the American College of Gastroenterologists is colonoscopy every 10 years for people with average colon cancer risk. The ACS recommends that average risk individuals begin screening at age 50 with one of the following:

  • Flexible sigmoidoscopy every 5 years, or
  • Colonoscopy every 10 years, or
  • Double-contrast barium enema every 5 years, or
  • CT colonography (virtual colonoscopy) every 5 years

(If any of these other tests are positive, a colonoscopy should be done.)

Individuals at higher risk of colon cancer should have screening earlier and potentially more frequently. Individuals at higher risk of colon and rectal cancer include:

  • Individuals with a family history of colon or rectal cancer in a relative who was diagnosed before the age of 60
  • Individuals with a history of polyps
  • Individuals with inflammatory bowel disease (Crohn's disease or ulcerative colitis)
  • Individuals with a predisposition to colon or rectal cancer, such as individuals with as hereditary non-polyposis colon cancer (HNPCC) syndrome or familial adenotous polyposis (FAP) syndrome

For more detailed information regarding screening for colon cancer, see the ACS site describing guidelines for screening for high-risk individuals and the American College of Gastroenterology document on screening guidelines for high-risk populations.

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