Women's Health Screenings by Age

Women should discuss when to start mammograms with their primary care provider based on age and family history. SSM Health care providers advise women to:

• Ask your provider if you should have a clinical breast exam (CBE) as part of your annual health exam.
• Become familiar with how your breasts normally look and feel by age 20. Although research shows no clear benefit to performing breast self-exams, being familiar with your breasts helps you recognize changes. Any change should be reported right away.
• Regular mammograms can help find breast cancer at an early stage. Discuss with your provider when you should begin screening with mammography.

Women with a high risk for breast cancer may begin screening early. Discuss timing with your primary provider if you:

• Have a lifetime risk of breast cancer of 20-25% or greater.
• Have a known BRCA1 or BRCA2 gene mutation.
  • Talk with a provider for more information about genetic counseling.
• Have a parent, brother, or sister with a BRCA1 or BRCA2 gene mutation.
• Had radiation therapy to the chest between the ages of 10 and 30 years.
• Have Li-Fraumeni Syndrome, Cowden Syndrome, Bannayan-Riley-Ruvalcaba Syndrome, or have a first-degree relative with one of these syndromes.

Nearly all cervical cancer is caused by a human papillomavirus, or HPV. There are more than 150 related viruses and some are known to cause cancer. The virus is sexually transmitted and so common that most sexually active adults have or have had an HPV infection at some point. Talk with your provider about cervical cancer screening recommendations.

Because HPV is so common, SSM Health providers recommend a vaccine for girls and boys aged 9-12. Teens and adults can also be vaccinated for HPV. Getting vaccinated against HPV helps protect against cancers of the cervix, throat, vulva, vagina, penis, and anus.

Talk with your primary care provider to determine when you should start colorectal cancer screening. Those with an average risk usually begin screening at age 45. Physicians will recommend one or more of the screening tests below based on family history and health issues:

• Highly sensitive fecal immunochemical test (FIT) every year
• Colonoscopy every 10 years
• CT colonography (virtual colonoscopy) every five years
• Flexible sigmoidoscopy every five years
• Double-contrast barium enema every five years

If you have any of the following risk factors for colorectal cancer, screening should begin at an earlier age and be provided more frequently:

• Personal history of colorectal cancer or adenomatous polyps
• Personal history of chronic inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
• Strong family history of colorectal cancer or polyps
• Family history of hereditary colorectal cancer syndromes
• Personal history of radiation to the abdomen or pelvic area

We recommend all women be informed about the risks and symptoms of endometrial cancer when they enter menopause. Report any unexpected bleeding or spotting to your doctor if you are menopausal.

If you have – or are at a high risk for – hereditary, non-polyposis colon cancer (HNPCC), you should begin receiving annual screenings for endometrial cancer at age 35. This is done with an endometrial biopsy.

Until recently, there wasn’t a screening tool for those at a higher risk for lung cancer. Factors that increase your risk include:

• Being a current or past smoker
• Long-term exposure to secondhand smoke
• Long-term exposure to heavy metals or radon at home

Caught early, lung cancer is highly treatable. But since there are no symptoms, it’s often not discovered until the cancer has become dangerous. Now, your SSM Health primary care provider can help you calculate if the exposure you’ve had in your lifetime puts you at risk of lung cancer.

Screening involves a low-dose CT scan which provides a highly detailed X-ray image of your lungs. The scan takes only a few minutes and is painless. Because these scans use radiation, they are used only when your calculated exposure indicates an elevated risk.

Who is eligible to be screened? People who:

• Are between age 50-77 and on Medicare or 50-80 years old and on commercial insurance, and
• Have a 20-pack-year tobacco smoking history (i.e., an average of one pack per day for 20 years), and
• Smoke now or have quit in the past 15 years.

Speak with your primary care provider regarding your risk of developing lung cancer.

More than 70% of oral cancers diagnosed today are caused by a human papillomavirus (HPV). As the use of tobacco has declined, oral cancers from smoking, chewing dip, snuff, and drinking excessive alcohol have also declined.

Of the more than 150 related viruses, a few are known to cause oral cancer. Most sexually active people will have this very common, sexually transmitted virus at some point. Healthy individuals usually clear this viral infection on their own. But sometimes the body is unable to clear itself and the result can be cancer.

Our physicians recommend all adults be screened annually. Most dentists now include oral cancer screenings for every adult patient annually. SSM Health provides an annual screening as well.