Cancer Screening by Age: The Complete Guide to Which Tests You Need and When

Cancer screening saves lives. Regular cervical screening can prevent most cervical cancers, bowel screening can find cancer early and remove polyps before they turn into cancer, and breast and lung screening can catch tumours when they are small and more treatable. Yet millions of people miss screening because they do not know which tests they need, feel embarrassed, are afraid of the result, or think screening is only for people with symptoms.

This guide explains what cancer screening is, which tests are recommended at which ages, how each test works, the benefits and the possible downsides, and how to make an informed choice. Programmes vary between countries, so always check what is offered where you live.

What is cancer screening?

Screening means testing people who have no symptoms to find cancer early, or to find changes that could become cancer, before they cause problems. It is different from tests done because someone has symptoms. Screening is offered to groups of people at a certain age or risk level where evidence shows that the benefits outweigh the harms.

Screening can:

• Prevent cancer by finding and treating pre-cancerous changes (for example, in cervical and bowel screening)
• Find cancer at an earlier stage, when treatment is more likely to succeed and may be less intensive
• Reduce deaths from certain cancers

Important: screening is not for symptoms

If you have symptoms that could be cancer, do not wait for a screening appointment. See a healthcare provider promptly. Warning signs include a new lump, unexplained bleeding (including after menopause, after sex, in urine or stools, or when coughing), a change in bowel habit lasting several weeks, unexplained weight loss, a persistent cough or hoarseness, difficulty swallowing, a sore that does not heal, a changing mole, and persistent unexplained pain or tiredness.

Benefits and harms: making an informed choice

No screening test is perfect. Understanding both sides helps you decide.

Possible benefits

• Finding cancer early, when it is easier to treat
• Preventing some cancers altogether
• Reassurance when results are normal

Possible harms

• False positives: a test suggests a problem that turns out not to be cancer, causing anxiety and further tests
• False negatives: a test misses a cancer, which may cause false reassurance
• Overdiagnosis: finding cancers that would never have caused harm in a person’s lifetime, leading to treatment that was not needed. This is a particular issue in breast and prostate screening
• Risks from follow-up tests, such as bleeding or bowel perforation from colonoscopy (rare)
• Radiation exposure from mammograms and CT scans, which is low

For the programmes recommended by national bodies, the evidence shows that benefits outweigh harms for the groups invited. Choosing whether to take part is your decision.

Cervical cancer screening

Who and when

Cervical screening is for women and people with a cervix. The World Health Organization recommends HPV DNA testing as the preferred screening method, starting at age 30 and repeated every five to ten years for the general population, and starting at 25 with testing every three to five years for women living with HIV. Many high-income countries start at 25 and continue to around 64 or 65.

Examples of current programmes:

• United Kingdom (England): HPV-based screening from 25 to 64; from July 2025, people aged 25 to 49 who test HPV negative are invited every five years
• United States: the US Preventive Services Task Force recommends screening from 21 to 65, with HPV testing every five years from age 30 (or cytology every three years); self-collection of samples is now an option in some settings
• Australia: HPV test every five years from 25 to 74, with self-collection available

How the test works

A nurse or other healthcare provider uses a speculum to see the cervix and a small soft brush to collect cells. It takes a few minutes and can be uncomfortable but should not be painful. Many countries now offer self-sampling, where you collect a swab from the vagina yourself, which is as accurate as a clinician-taken sample for HPV testing.

The sample is tested for high-risk types of human papillomavirus (HPV), which cause almost all cervical cancers. If HPV is found, the sample is checked for abnormal cells, and you may be invited for colposcopy, a closer look at the cervix, where abnormal areas can be treated.

HPV vaccination

HPV vaccination, recommended for girls and increasingly boys aged 9 to 14, prevents most cervical cancers. WHO now supports a single dose for this age group. Vaccinated people should still attend cervical screening.

Elimination goal

WHO’s global strategy to eliminate cervical cancer sets 90-70-90 targets for 2030: 90 percent of girls fully vaccinated against HPV by 15, 70 percent of women screened with a high-performance test by 35 and again by 45, and 90 percent of women with pre-cancer or cancer receiving treatment.

Breast cancer screening

Who and when

Breast screening uses mammography, an X-ray of the breasts. Programmes vary:

• United States: the USPSTF updated its recommendation in 2024 to screening every two years from 40 to 74
• United Kingdom: every three years from 50 to 71
• European Union: European guidelines recommend screening from 45 to 74, with frequency depending on age
• Many other countries offer screening from 50 to 69, every two years

In many lower-resource settings, where mammography is not widely available, the focus is on breast awareness, clinical breast examination and rapid assessment of symptoms, which WHO’s Global Breast Cancer Initiative promotes.

How the test works

Each breast is placed between two plates and pressed for a few seconds to take X-ray images. It can be uncomfortable. Results are usually sent within a few weeks. About 1 in 25 people are called back for further tests, and most of them do not have cancer.

Higher risk

Women with a strong family history, known gene changes such as BRCA1 or BRCA2, or previous chest radiotherapy may be offered earlier and more frequent screening, sometimes with MRI. Ask your healthcare provider about a referral if close relatives had breast or ovarian cancer, especially at a young age.

Dense breasts

Dense breast tissue makes mammograms harder to read and slightly increases cancer risk. In some countries, women are now informed about their breast density, and additional imaging may be discussed.

Breast awareness

Whatever your age, know how your breasts normally look and feel, and report changes such as a lump, thickening, skin dimpling, nipple changes or discharge, or a rash on the nipple. Men can get breast cancer too.

Bowel (colorectal) cancer screening

Who and when

Bowel cancer is one of the most common cancers worldwide and is increasingly being diagnosed in younger adults. Screening ages vary:

• United States: from 45 to 75, with several test options
• United Kingdom: home FIT test every two years from 50 to 74 in England (the programme has been lowered from 60)
• Australia: home FIT test every two years from 45 to 74
• Many European countries: from 50 to 74

Types of tests

• Faecal immunochemical test (FIT): a home test that detects tiny amounts of hidden blood in a stool sample. If positive, colonoscopy follows.
• Colonoscopy: a camera examines the whole large bowel, and polyps can be removed during the test. In the US, it is offered every 10 years as a screening option.
• Stool DNA tests and CT colonography are options in some countries.
• Flexible sigmoidoscopy examines the lower part of the bowel.

Higher risk

People with a strong family history of bowel cancer, inherited conditions such as Lynch syndrome, or long-standing inflammatory bowel disease may need colonoscopy surveillance from an earlier age.

Symptoms not to ignore

Blood in your stools, a change in bowel habit lasting more than three weeks, unexplained weight loss, abdominal pain or a lump, and unexplained tiredness from anaemia should be checked whatever your age.

Lung cancer screening

Who and when

Lung cancer is the leading cause of cancer death worldwide. Screening with low-dose CT scans can reduce deaths in people at high risk because of smoking.

• United States: yearly low-dose CT for adults aged 50 to 80 with a 20 pack-year smoking history who currently smoke or quit within the past 15 years
• United Kingdom: a national targeted lung cancer screening programme is being rolled out for people aged 55 to 74 who have ever smoked, with a risk assessment first
• Several other countries, including Australia (from July 2025), Croatia, Poland and South Korea, have introduced or are introducing programmes

A pack-year means smoking 20 cigarettes a day for one year. Twenty pack-years could be one pack a day for 20 years or two packs a day for 10 years.

Stopping smoking

Screening is not a substitute for stopping smoking, which is the most effective way to reduce lung cancer risk. Many screening programmes include stop-smoking support.

Prostate cancer testing

Prostate cancer screening is more controversial because the PSA blood test can lead to overdiagnosis of slow-growing cancers that would never cause harm, and to treatments with side effects such as erectile dysfunction and incontinence.

• United States: the USPSTF recommends that men aged 55 to 69 make an individual decision with their healthcare provider about PSA testing; routine screening is not recommended at 70 and over
• United Kingdom: there is no national screening programme; men over 50 can ask for a PSA test after discussing the pros and cons. The UK National Screening Committee has reviewed targeted screening for men at higher risk
• European Union: the EU Council recommended in 2022 that countries evaluate organised PSA-based programmes combined with MRI

Black men and men with a family history of prostate cancer or BRCA2 gene changes are at higher risk and may benefit from discussing testing from an earlier age, often from 45. Modern pathways using MRI before biopsy and active surveillance for low-risk cancers have reduced some of the harms of testing.

Liver cancer surveillance

People with cirrhosis or chronic hepatitis B at high risk are usually advised to have a liver ultrasound every six months, sometimes with an alpha-fetoprotein blood test. This applies especially in Africa and Asia, where hepatitis B and liver cancer are common.

Other cancers

• Skin cancer: there is no general population screening in most countries, but check your skin and report changing moles. Australia focuses on sun protection and awareness.
• Ovarian cancer: no effective screening test exists for the general population. Know the symptoms: persistent bloating, feeling full quickly, pelvic or abdominal pain and needing to urinate more often.
• Oral cancer: dentists check the mouth during routine examinations; India has included oral screening in some programmes.
• Stomach cancer: countries with high rates, such as Japan and South Korea, offer endoscopic screening.
• Testicular cancer: no formal screening, but young men should be aware of lumps or swelling.

A decade-by-decade guide

This is a general guide based on common international recommendations. Check your own country’s programme and discuss your personal risk.

In your 20s

• Cervical screening from 21 or 25 in many countries
• HPV vaccination catch-up if eligible
• Breast and testicular awareness; skin checks
• Know your family history

In your 30s

• Cervical screening (WHO recommends starting HPV testing at 30)
• Earlier breast screening if you are at high risk
• Stop smoking, limit alcohol, stay active

In your 40s

• Cervical screening continues
• Breast screening from 40 (US) or 45 to 50 elsewhere
• Bowel screening from 45 in some countries
• Prostate discussion from 45 for higher-risk men

In your 50s and 60s

• Bowel screening
• Breast screening
• Cervical screening until around 64 or 65
• Lung screening if you have a significant smoking history
• PSA discussion for men

70 and beyond

• Some programmes continue to 74 or 75
• Decisions about continuing screening depend on health, life expectancy and personal preference
• Symptoms should always be checked regardless of age

Barriers to screening and how to overcome them

• Embarrassment: nurses perform these tests every day. You can ask for a female or male clinician, bring a chaperone, or use self-sampling where offered.
• Fear of the result: most results are normal, and finding problems early makes treatment easier.
• Past trauma: if intimate examinations are distressing because of past experiences, tell the clinician. They can adjust the approach, go slowly and stop whenever you ask.
• Disability: ask for reasonable adjustments, such as longer appointments, accessible equipment or easy-read information.
• Cost and access: many screening programmes are free; ask your local health service.
• Language: request an interpreter if needed.

Reducing your cancer risk

The World Health Organization estimates that 30 to 50 percent of cancers could be prevented by avoiding risk factors and using existing prevention strategies.

• Do not smoke or use tobacco in any form
• Limit alcohol; there is no completely safe level for cancer risk
• Maintain a healthy weight
• Be physically active
• Eat plenty of vegetables, fruit, whole grains and fibre, and limit processed and red meat
• Protect your skin from the sun
• Get vaccinated against HPV and hepatitis B
• Reduce exposure to air pollution and workplace carcinogens where possible

The nurse’s role

Nurses carry out cervical screening, run screening clinics, support people through colonoscopy and follow-up, deliver HPV and hepatitis B vaccination, and help people understand results and make informed decisions. Practice nurses are often the best people to ask what you are due for.

What happens after an abnormal result

An abnormal screening result is not a cancer diagnosis. It means more tests are needed to find out what is going on. Knowing what to expect can reduce anxiety.

Cervical screening

If high-risk HPV is found but cells are normal, you will usually be invited back for another test in about a year, as most HPV infections clear on their own. If abnormal cells are found, you will be invited for colposcopy. During colposcopy, a specialist nurse or other clinician examines the cervix with a magnifying instrument, applies liquids that highlight abnormal areas, and may take a small biopsy. Abnormal areas (CIN, cervical intraepithelial neoplasia) can often be removed in the same visit using a thin heated wire loop (LLETZ), under local anaesthetic. Most people need no further treatment beyond follow-up tests.

Breast screening

If you are called back, you will usually have more mammograms, an ultrasound and sometimes a needle biopsy at a breast assessment clinic. Most people who are called back do not have cancer. If cancer is found, many screen-detected cancers are small and can be treated with surgery that conserves the breast.

Bowel screening

A positive FIT result means blood was found, which may come from polyps, haemorrhoids, inflammation or cancer. You will usually be offered a colonoscopy. Many people have polyps removed during the procedure, which prevents them from becoming cancer. A minority are found to have cancer, often at an early stage.

Lung screening

Small nodules are very common on lung CT scans and most are not cancer. You may be invited for a repeat scan in a few months to see whether a nodule changes. Larger or growing nodules are investigated further, sometimes with a PET scan or biopsy.

Coping while you wait

Waiting for further tests can be stressful. Ask how long results will take and who to contact with questions. Talking to someone you trust, staying busy and avoiding late-night searching online can help. Many screening services have specialist nurses who can explain what is happening.

Screening and inequality

Screening uptake is often lower among people living in deprived areas, some ethnic minority groups, people with learning disabilities, people with severe mental illness, homeless people, migrants and people in prison. These same groups often have higher cancer death rates. Health services are increasingly using approaches such as text reminders, self-sampling, community health workers, translated materials and outreach clinics to close the gap. If you work in health or community settings, encouraging and supporting people to attend screening can save lives.

Frequently asked questions

I feel well. Do I still need screening?

Yes. Screening is designed for people without symptoms; early cancers often cause none.

I have had the HPV vaccine. Do I still need cervical screening?

Yes. The vaccine does not protect against all high-risk HPV types.

Can I do bowel screening at home?

Yes, FIT kits are completed at home and posted back in many programmes.

Does a normal result mean I will never get cancer?

No. It means no problem was found at the time. Keep attending when invited and report symptoms.

What if I am transgender or non-binary?

Screening depends on the organs you have. For example, trans men with a cervix should have cervical screening. Talk to your healthcare provider about what applies to you.

But what if they find something?

That fear is natural, and it stops many people from attending. But screening is designed to find problems when they are small and treatable. Many abnormal results are pre-cancerous changes that can be treated simply. Finding cancer early gives you more options and a much better chance of cure. Not knowing does not make a problem go away; it only gives it time to grow.

Related: Cervical screening and HPV test · Mammogram: what to expect · Prostate cancer and PSA

Sources: World Health Organization (cervical cancer elimination strategy; screening guidelines; Global Breast Cancer Initiative; cancer fact sheet), US Preventive Services Task Force, UK National Screening Committee and NHS screening programmes, European Commission Initiative on Breast Cancer, Council of the European Union recommendation on cancer screening (2022), Cancer Australia.