🌱 Health Promotion · Lesson 4 of 6 · 6 min
Who Gets Screened for What, and When
🔬 A healthy 45-year-old asks what checkups she is 'due for'. There is a real list, with real ages, and the exam will hand you a client and ask which screening is overdue.
💡 Key idea
Colon 45, mammogram 40 every two years, Pap from 21, lung CT for heavy smokers 50 to 80, AAA ultrasound for men 65 to 75 who smoked, bone density for women at 65.
🧠 Why it matters
Common adult screenings from the U.S. Preventive Services Task Force: COLORECTAL cancer screening from age 45 to 75 (colonoscopy every 10 years or stool-based tests more often); BREAST cancer mammography every 2 years from age 40 to 74; CERVICAL cancer with cytology every 3 years from 21 to 29, and from 30 to 65 either cytology every 3 years or high-risk HPV testing, alone or with cytology (cotesting), every 5 years; HPV testing alone is increasingly preferred, and it can use a self-collected sample; LUNG cancer yearly low-dose CT from 50 to 80 for people with a 20 pack-year history who smoke or quit within the past 15 years; ABDOMINAL AORTIC ANEURYSM one-time ultrasound for men 65 to 75 who have ever smoked; OSTEOPOROSIS bone density for women 65 and older; BLOOD PRESSURE for all adults; DIABETES screening for adults 35 to 70 who are overweight or obese; HIV screening at least once for ages 15 to 65; DEPRESSION screening for all adults and adolescents. Prostate cancer screening with PSA for men 55 to 69 is an individual, shared decision rather than routine. Guidelines change; the exam tests the current ones.
🏥 In the real world
📅 A 52-year-old man who smoked a pack a day for 25 years and quit 10 years ago believes he is 'done worrying about smoking'. He qualifies for annual low-dose CT lung screening until 15 years have passed since quitting, and he is overdue for colorectal screening, which started at 45. Two conversations, both potentially life-saving, both missed if the nurse does not know the ages.
📌 Takeaways
- Colorectal screening starts at 45; mammography at 40 every two years
- Cervical: every 3 years from 21; HPV-based every 5 years from 30
- Lung CT: 20 pack-years, ages 50 to 80, smoking or quit within 15 years
✅ Test yourself
A 46-year-old woman with no risk factors asks which cancer screening she should have started by now. Which is correct?
- Abdominal aortic aneurysm ultrasound
- Lung cancer CT
- Colorectal cancer screening
- Bone density scan
Answer: C · Colorectal cancer screening
Colorectal screening begins at 45 for average-risk adults. Bone density starts at 65, lung CT needs a heavy smoking history, and AAA screening applies to men 65 to 75 who smoked.
Which client meets criteria for annual low-dose CT lung cancer screening?
- A 55-year-old who never smoked but has a family history
- A 45-year-old who smoked 1 pack a day for 10 years
- A 70-year-old who quit smoking 25 years ago
- A 60-year-old who smoked 1 pack a day for 30 years and quit 5 years ago
Answer: D · A 60-year-old who smoked 1 pack a day for 30 years and quit 5 years ago
Age 50 to 80, at least 20 pack-years, and currently smoking or quit within 15 years.
Per the USPSTF, what is the recommended interval for screening mammography in an average-risk woman aged 40 to 74?
- Every 2 years
- Once at age 50
- Every year
- Every 5 years
Answer: A · Every 2 years
The current USPSTF recommendation is every two years from 40 to 74.
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