Getting a cancer screening usually starts with a visit to your primary care doctor, who will assess your age, family history, and risk factors, then order the appropriate tests. Some screenings require a doctor’s order and an appointment at a specific facility, while others allow walk-ins. The type of screening you need depends on which cancers you’re eligible to be screened for, and guidelines vary significantly by cancer type.
Start With Your Primary Care Doctor
The most straightforward path is to bring up cancer screening at your next regular checkup. Your doctor, nurse practitioner, or physician assistant will review your overall health, family history, lifestyle, and age to determine which tests are recommended and how often you should get them. Their office will then schedule the tests, tell you where to go, and follow up with results.
If you don’t currently have a primary care doctor, you have several options. You can check your insurance company’s provider directory, ask family or friends for referrals, call a local hospital, or contact your local health department. Many community health centers and women’s clinics can also order screening tests. Specialists like gynecologists may order breast and cervical cancer screenings directly.
Before you go to the screening facility, call ahead. Some locations require a prescription from your doctor and a scheduled appointment. Others, particularly for certain stool-based tests, may not.
Which Screenings You’re Eligible For
Not every adult needs every screening. The tests recommended for you depend on your age, sex, and specific risk factors. Here are the major cancer screenings and who should get them.
Breast Cancer
Women should get a screening mammogram every two years starting at age 40 and continuing through age 74. This applies to women at average risk. If you have a family history of breast cancer or other risk factors, your doctor may recommend starting earlier or screening more frequently.
Cervical Cancer
Women aged 21 to 29 should get a Pap test every three years. Starting at age 30 through 65, you have a few options: a Pap test alone every three years, an HPV test alone every five years, or both tests together every five years. After 65, most women can stop screening if their recent results have been normal.
Colorectal Cancer
Most people should begin colon cancer screening soon after turning 45 and continue through age 75. There are two main approaches. A colonoscopy is done every 10 years for people at average risk. If you’d rather avoid the prep involved in a colonoscopy, a stool-based test called FIT can be done at home once a year. It detects blood in your stool using a simple kit your doctor provides. If the stool test comes back positive, you’ll need a follow-up colonoscopy.
Lung Cancer
Annual screening with a low-dose CT scan is recommended for adults aged 50 to 80 who have a significant smoking history: at least 20 pack-years (meaning one pack a day for 20 years, or two packs a day for 10 years, and so on). You qualify if you currently smoke or quit within the past 15 years. If you’ve never smoked, this screening doesn’t apply to you.
Prostate Cancer
There is no blanket recommendation for routine prostate screening. For men aged 55 to 69, the decision to get a PSA blood test is a personal one that should involve a conversation with your doctor about the potential benefits and risks. PSA testing can detect cancer early, but it also frequently flags conditions that aren’t cancer, which can lead to unnecessary biopsies and anxiety. Men 70 and older are generally advised against routine PSA screening.
Skin Cancer
There is no standard screening schedule for skin cancer in people at average risk. The majority of melanomas are discovered either by patients noticing a suspicious spot themselves or by a doctor finding one incidentally during an exam. If you have a personal or family history of skin cancer, or you notice a mole that’s changing in size, shape, or color, bring it to your doctor’s attention directly rather than waiting for a routine screening.
Screening vs. Diagnostic Testing
A screening test is routine testing for people without symptoms. It’s scheduled based on your age and risk profile, not because something feels wrong. A diagnostic test, by contrast, investigates a symptom you’re experiencing or follows up on something abnormal found during a screening. This distinction matters for your wallet.
If a colonoscopy is performed as a screening and a polyp is found and removed during the procedure, it can be reclassified from screening to diagnostic. That reclassification may change what you owe. Screening tests typically have no copay, while diagnostic tests may involve copays, coinsurance, or deductible charges. If you’re unsure how a test will be billed, check with both your doctor’s office and your insurance company before the appointment.
What Insurance Covers
Under the Affordable Care Act, most private insurance plans must cover recommended preventive screenings with no out-of-pocket cost to you. This includes colorectal cancer screening for adults 45 to 75, lung cancer screening for eligible high-risk adults 50 to 80, mammograms, cervical cancer screening, and other tests that carry an A or B recommendation from the U.S. Preventive Services Task Force. You pay nothing as long as you use an in-network provider and the test is classified as a screening rather than diagnostic.
Medicare also covers many cancer screenings, though the specific rules around frequency and cost-sharing differ from private insurance. Check with Medicare directly or review your plan’s preventive services summary.
Options If You’re Uninsured
The National Breast and Cervical Cancer Early Detection Program, run by the CDC, provides free or low-cost breast and cervical cancer screenings. You may qualify if your yearly income is at or below 250% of the federal poverty level, you’re uninsured or your insurance doesn’t cover screening, and you’re between 40 and 64 for breast cancer screening or 21 to 64 for cervical cancer screening.
Beyond that federal program, many local hospitals, community health centers, and health departments offer cancer screening services on a sliding fee scale. Calling your local health department is a good starting point if you’re unsure what’s available in your area. Some facilities host periodic free screening events, particularly for breast and colorectal cancer, so it’s worth asking about upcoming opportunities when you call.