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Useful guidance as you consider when and how to safely resume cancer screening

​If you have signs or symptoms of cancer, you should consult your doctor or a health provider right away

At the onset of the COVID-19 pandemic, elective medical procedures, including cancer screening, were largely put on hold to prioritize urgent needs and reduce the risk of the spread of COVID-19 in healthcare settings. One consequence of this has been a substantial decline in cancer screening.

As states and other authorities re-open businesses and ease restrictions, many healthcare facilities are starting to offer elective procedures again, including cancer screening. Restarting cancer screening requires careful consideration of the risks and benefits of screening, along with ensuring safety for both patients and healthcare personnel.  

Decisions about restarting screening depend on many factors, and they may not be the same for every person. They will likely vary by community while the pandemic continues.

Regular cancer screening is still important

If you had an appointment for screening that was postponed or canceled, talk to your healthcare team about when to reschedule. Your provider can discuss balancing the risks and benefits of being screened now or postponing for a later date, taking into account your personal and family history, other risk factors, and the timing of your last screening test.

It is also important to keep in mind that we’re focusing here on cancer screening. Screening tests look for cancer in people who don’t have symptoms. These tests are different from tests your doctor might order if you have symptoms that could be from cancer. If you have signs or symptoms that might be from cancer, for instance, a lump in the breast or blood in the stool, you should discuss this with your provider right away, as you will need exams or tests that evaluate those particular signs and symptoms. 

You may have options for screening 

Screening recommendations are general recommendations for large groups of people, but there may be flexibility for some screening tests. For example:

Many women get cervical cancer screening every year. However, no organization recommends cervical cancer screening with a Pap test any more often than every 3 years, and if an HPV test is used, no more often than every 5 years. If you have had normal test results in the past, getting cervical cancer screening at this time is not urgent.

Many women get an annual mammogram for breast cancer screening.  However, leading organizations that issue screening guidelines recommend that average risk women ages 55 and older can be screened every two years. If you are 55 or older and had a normal mammogram within the last year, you could choose to have your next mammogram up to 24 months after your last one.

There are several options for colorectal cancer screening for people at average risk. For example, stool tests, such as fecal immunochemical testing (FIT) or a stool DNA test (such as Cologuard), can be done safely at home. If the stool test result is positive, you will need a colonoscopy, and it will be important to talk with your doctor about the safest way to proceed with this. Colonoscopy as a screening test is still an option, but it may be harder to get an appointment now compared to before the COVID-19 pandemic.

Your health care provider can help you determine what screening schedule and which screening tests are best for you at this time.

Screening needs to be done safely

As your regular facility for health care returns to providing cancer screening, it’s important that it is done as safely as possible. The U.S. Centers for Disease Control and Prevention (CDC) has recommendations for healthcare facilities to reduce the risk of COVID transmission:

  • Screening centers should be available to answer questions from patients via phone or web portal before and/or after the screening procedure.
  • Patients should be pre-screened for COVID-related symptoms before screening appointments.
  • Scheduling of appointments should allow for physical distancing between patients, and longer appointment times, if needed, to avoid crowding in waiting rooms and patient care areas.
  • There should be limitations on visitors other than patients and/or their caregivers into the screening facility.
  • If not done in front of you, the screening center should be able to tell you how often equipment and surfaces are disinfected and cleaned.
  • Everyone, including patients and staff, should wear a face covering or face mask, where appropriate. There should be frequent handwashing and use of hand sanitizer by staff, patients, and visitors.

Every community has its own unique situation and will need to rely on the judgment of the health care professionals and leaders in the community to make the best decisions possible.

This information is intended to help you understand the importance of returning to regular cancer screening as soon as it is safe to do so. At the same time, it’s important to remember that if you have signs or symptoms of cancer, or if you have additional risk factors that put you in a high-risk group, you should consult your doctor or a health provider right away for guidance.

For more about cancer and COVID-19, visit cancer.org/coronavirus.

As always, ACS is available through live chat or by phone anytime, day or night, at 1-800-227-2345.

PLEASE NOTE: This information was written by Laura Makaroff, DO, senior VP, prevention and early detection; Durado Brooks, MD, MPH, VP, prevention and early detection; and Bob Smith, PhD, senior VP, cancer screening, in collaboration with cancer.org's medical content team. For a link to this story on cancer.org, where it originated, click here.


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