The American College of Physicians has issued an evidence-based guide for cancer screening, with the following recommendations:

Breast Cancer

• Women aged 40 to 49 years: discuss benefits and harms of mammography, and if patient requests, order mammogram every 2 years.

• Women aged 50 to 74 years: encourage biannual mammograms

Cervical Cancer

• Women aged 21 to 29 years: cytology testing every 3 years

• Women aged 30 to 65 years: cytology testing every 3 years or cytology and HPV testing every 5 years

Colorectal Cancer

• Adults aged 50 to 75 years: use one of the following strategies:

o High sensitivity FOBT or FIT annually

o Sigmoidoscopy every 5 years

o Combined high-sensitivity FOBT or FIT every 3 years, plus sigmoidoscopy every 5 years

o Optical colonoscopy every 10 years

Ovarian Cancer

• No screenings recommended

Prostate Cancer

• Men aged 50 to 69 years: in patients who ask about PSA-based screenings and have at least a 10-year life expectancy, discuss the benefits and harms of screenings. If an informed patient requests PSA testing, order the screening no more than every 2 to 4 years.

Citation: Wilt TJ, Harris RP, Qaseem A; High Value Care Task Force of the American College of Physicians. Screening for cancer: advice for high-value care from the American College of Physicians. Ann Intern Med. 2015;162(10):718-725. doi:10.7326/M14-2326.

Commentary: This article looks at standard recommendations from a number of organizations to come up with their recommendations for “high value screening.” High value screening is defined as, “the lowest screening intensity threshold at which organizations agree about screening recommendations.” The idea here is that a higher intensity of screening does not necessarily lead to higher value and that the goal of high-value screening is to maximize the benefits and minimize the risk. This provides a nice summary of important high value cancer screening. — Neil Skolnik, MD