The Cancer Screenings Every Young Woman Should Get
You were probably shocked when Catherine, Princess of Wales, announced that she had cancer. Not only because of the rumors swirling around her in the weeks before but because she is only 42—and seemingly the epitome of health.
It’s true that cancer in young adults is very uncommon—only about 12 percent of all cases occur in people under the age of 50, according to the American Cancer Society. But cancer rates are increasing in this age group. A study published in 2023 in BMJ Oncology found that rates across the globe have dramatically increased in people under the age of 50 over the past couple decades. There were 3.26 million early onset cancer cases in 2019, an increase of 79.1 percent since 1990.
Another study, published this past January in JAMA Network Open, found that the incidence of breast cancer among women younger than 50 rose by almost 4 percent each year between 2016 and 2019. “We’ve seen increases in all sorts of cancers, including breast, colorectal, pancreatic, head and neck, and reproductive cancers like ovarian and endometrial cancer,” says Veda Giri, MD, director of the Early-Onset Cancer Program at Yale School of Medicine.
While it’s not quite clear why this is happening, some of it may be due to lifestyle factors like being overweight or having obesity, being sedentary, drinking alcohol, and smoking, she explains. “We’re also looking at environmental exposures, as well as changes to people’s microbiome, or the mix of bacteria that makes up your GI tract.”
The good news is that screening tests are still key to catching cancer in the early stages, when it’s most treatable. Here are the ones you should get, depending on your age and other risk factors.
Essential
HPV test
The American Cancer Society recommends that all women start at age 25, says Ahmedin Jemal, PhD, senior vice president of Surveillance & Health Equity Science at the American Cancer Society. The test checks to see if you’re infected with a high-risk form of HPV, the virus that causes cervical cancer. It’s done the same way as a Pap test: Your doctor will use a special tool to scrape your cervix to remove cells for testing. It’s worth checking in to see if your primary care provider offers the test; otherwise, you can have it done at your OB’s office or local Planned Parenthood center.
Mammogram
“In general, we recommend that all women at average risk of breast cancer start their annual screening mammogram at age 40,” says Shari Goldfarb, MD, a breast oncologist, researcher, and director of the Young Women with Breast Cancer Program at Memorial Sloan Kettering Cancer Center in New York City. The American Cancer Society also says that all women should begin screening mammograms every year between the ages of 40 and 44 until age 55, when they can discuss with their doctor whether to switch to every other year.
According to the Centers for Disease Control and Prevention, about half of all women over the age of 40 have dense breasts, meaning it may be harder to spot breast cancer tumors on a mammogram, in which case your radiologist will note it in your report so you get an annual ultrasound as well.
Women who have a first-degree relative—meaning a mother, sister, or daughter—with a history of breast cancer should start their mammograms 10 to 15 years earlier than the age of the family member when they developed breast cancer, says Goldfarb.
Colonoscopy
The American Cancer Society now recommends that people at average risk of colorectal cancer start regular screening at age 45. It was moved from age 50 a few years ago, due to a rise in diagnoses in younger adults, says Robin Mendelsohn, MD, a gastroenterologist and codirector of Center for Young Onset Colorectal and Gastrointestinal Cancer at Memorial Sloan Kettering Cancer Center in New York City.
Colonoscopies are generally recommended over other tests like stool tests, says Mendelsohn: “A colonoscopy can not only diagnose colorectal cancer; it can also prevent it because it can find and remove potentially precancerous polyps.” Plus, if your stool sample tests positive for blood, you’ll have to have a colonoscopy anyway. Your doctor may also offer a CT colonography, also called a virtual colonoscopy, which uses x-ray equipment to examine your colon and rectum.
If the results are normal, regular colonoscopies are repeated every 10 years, while virtual ones are needed every five years. Talk to your doctor if you have risk factors such as an inflammatory bowel disease like Crohn’s disease or ulcerative colitis, or a family history of colorectal cancer—you may need to start colon cancer screenings earlier.
Even under age 45, it’s still important to be alert for symptoms of colorectal cancer. The most common sign among younger adults is rectal bleeding, according to a 2022 study Mendelsohn published in the International Journal of Colorectal Disease. If you notice any blood when you have a bowel movement, let your doctor know. “Most of the time, it’s not due to colorectal cancer, but it should always be evaluated,” she says.
Skin cancer screening
The most common types of cancer among all adults are non-melanoma skin cancers, known as basal cell and squamous cell carcinoma skin cancers, says Jemal. Women under the age of 50 are more likely to develop melanoma than any other cancer except breast and thyroid cancers, per the Skin Cancer Foundation. See a dermatologist once a year for a skin check, or more often if you have other risk factors, like a personal or family history of skin cancer. You should also do your own at home skin check once a month. You can get tips on what to look for here.
Useful for some people
Breast MRI
If you are at increased risk of developing breast cancer, talk to your doctor about the best age to start an annual mammogram and breast MRI—it could be as young as 20, says Goldfarb. Additionally, if you have a family history of breast cancer or a certain cluster of cancers, like breast, ovarian, and pancreatic cancer, ask your doctor about genetic testing. This type of testing can help you know whether you need to make lifestyle changes, have more frequent screening, or take preventative action (which includes everything from taking medication to manage colorectal cancer risk to having a mastectomy to reduce the chances of developing breast cancer). Women at higher risk will usually be referred to a high-risk screening program, says Goldfarb, where doctors will assess your lifetime risk of breast cancer and determine whether or not you’ll benefit from more intensive screening.
Lung cancer screening
If you’re between the ages of 50 and 80 and a current or former smoker, ask your doctor if you should have an annual low-dose CT scan to check for lung cancer. The American Cancer Society has guidelines about who can benefit from screening—see if you meet the criteria here.
Skip it
At-home genetic tests
You’ve probably seen the direct-to-consumer genetic tests that promise to assess your risk for breast cancer. The problem is, the most common ones like 23andMe only test for a bunch of variants in the BRCA1 and BRCA2 genes—and there are literally thousands of variants, says Giri. “It can provide a sense of false reassurance.”
Full-body MRI scans
Some MRI clinics advertise full-body scans, claiming they’ll examine you literally from head to toe for signs of cancer. But groups like the American College of Radiology don’t recommend them. There’s no evidence that they save lives or even pick up more cases of cancer than standard screenings.
If you’re worried about cancer—and let’s face it, most of us are—your best strategy is to commit to a healthy lifestyle that includes staying at a healthy weight, getting plenty of exercise, and eating a healthy diet, stresses Giri. These three things could prevent over 40 percent of all cancers, says the World Cancer Research Fund International. Combine them with staying up-to-date on screenings, and you’ll dramatically increase your chances of staying well for decades to come.
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