Few words can evoke such a visceral reaction as cancer. But "cancer" is a blanket term that encompasses more than 100 types and subtypes and survival rates from as low as 13% all the way up to 99%.

Across all cancers today, the five-year survivorship rate averages 69% — up 20 percentage points from 50 years ago.

To be sure, the last thing anyone wants to hear is "you have cancer," regardless of stage or type. But the fact of the matter is, depending on stage and type, many cancer diagnoses aren't as scary as they once were.

They also occur more than you might think. According to the American Cancer Society, one in two men and one in three women will develop cancer at some point in their life. The society goes so far as to say everyone is at some risk of developing cancer, but lifestyle factors such as smoking, unhealthy diets and even alcohol consumption can increase one's personal risk. Age, however, is a shared risk across all cancers, with more than 88% of cancers diagnosed at age 50 and above.

That's why preventative care against diseases like cancer, and early detection methods, like screenings through your primary care provider, are so important, says Dr. Kirtan Nautiyal, an oncologist at Houston Methodist.

"Cancer screening is a big part of primary care, but fear unfortunately stops many people from getting screened," says Dr. Nautiyal. "It's the idea of 'I don't want to find anything, so I'm not going to look,' and I completely understand that fear. Many, myself included, make rationalizations to avoid proactive and preventative measures, but it's much better to do these screenings when they're available and can prevent so much grief and worry on your end."

The goal of screening is to find cancer early, before it has the chance to grow, spread and cause symptoms and when treatment is more effective. But not all screenings — nor screening guidelines — are created equal.

Several expert groups have developed their own cancer screening guidelines. Below, we include the American Cancer Society's recommendations for five main cancers, plus some much-needed clarity from Dr. Nautiyal.

1. Breast cancer screening

"It's possible for patients in their 20s and 30s to present with a lump in their breast, but statistically speaking, they're less likely to be cancer in that age group," says Dr. Nautiyal. "That said, if a breast self-exam reveals anything [like a lump], then it should be worked up with a mammogram and potentially further testing."

If your mammogram comes back abnormal, don't panic. Ninety percent of abnormal mammograms are not breast cancer, but your doctor may order more tests to know what's going on. That's why a full discussion between you and your doctor is so important when it comes to breast cancer screening.

(Related: Breast Cysts vs. Cancer: How to Tell the Difference)

2. Prostate cancer screening

"Screening for prostate cancer isn't as clear cut as breast or colon cancer, which have more blanket recommendations," says Dr. Nautiyal. "For certain cancers, there are very sensitive and specific mechanisms for screening, but for prostate cancer, the test either doesn't pick up enough or picks up a bunch of junk that isn't even cancer and gets people very worried about it."

Dr. Nautiyal says that an elevated PSA test can indicate several things besides prostate cancer, such as a benign enlargement of the prostate or an infection, which may necessitate a biopsy of the prostate.

"In higher risk groups, you're more likely to find something abnormal, but even so, it's an important they have a discussion of what a positive PSA test means, understanding that it may necessitate further testing that proves to show nothing," says Dr. Nautiyal.

"If you're 55, you may say I'll do anything, but for much older patients, is screening worth it at that point? That's still an open question," he adds.

3. Lung cancer screening

In the past, the guidelines excluded former smokers who quit more than 15 years prior to beginning screening. However, the American Cancer Society amended their guidelines in 2023 to remove the years-since-quitting restriction, so any former smoker who meets the other two criteria is eligible.

4. Colorectal cancer screening

For people under 50, colorectal cancer is now the leading cause of cancer death in men and the second leading cause in women, behind only breast cancer, which is why it's so important for younger people to know the signs and symptoms of colon cancer, says Dr. Nautiyal.

"For younger people, there's a tendency to try and explain these symptoms away, and that often leads to a delay in diagnosis," says Dr. Nautiyal. "Not only that, but their physicians may not immediately initiate gastrointestinal testing. We should not necessarily blow them off just because they're in their 20s or 30s."
He further adds, "I'm not saying anybody with abdominal pain should get screened for colon cancer, but a combination of symptoms, like rectal bleeding, unexplained weight loss, and changes in stool, are triggers for me to investigate a little further."

(Related: PODCAST: Why are Younger Adults Getting Diagnosed with Colorectal Cancer?)

Anyone with a first-degree relative (e.g., parent, sibling, or child) diagnosed with colorectal cancer before 60 years old should start screening at age 40, or 10 years before the first diagnosis in their family — whichever comes first. For example, if your dad was diagnosed with colorectal cancer at 46, then screening should begin at 36. Other higher-risk patients, such as those with inflammatory bowel disease, should talk to their doctor about when to begin screening.

With several options to choose from, it's important you talk to your doctor to decide which screening is best for you.

5. Cervical cancer screening

That said, as most cervical precancers develop slowly, cervical cancer can usually be prevented through regular screening. Gardasil 9, the HPV vaccine, protects against 90% of cancer-causing HPV, plus five other types of cancer. However, anyone — regardless of vaccination — should still be screened.

(Related: 8 Things Every Woman Needs to Know About Cervical Cancer)

HPV tests are more effective than pap tests because they look for HPV infections before abnormal cells occur. They're also more effective at identifying individuals at risk for cervical adenocarcinoma, which accounts for about 30% of all cervical cancers and is more often missed by pap testing.

How can I know my risk for developing certain cancers?

You may be wondering: What's my own cancer risk?

That's the thing about cancer. The causes aren't well understood for most types. However, research shows there are factors within our realm of influence. Smoking is perhaps the most famous carcinogen. But there are a host of factors, from your drinking habits to diet, that Dr. Nautiyal says your primary doctor should know about to help determine your personal risk.

"Having your primary care doctor take a thorough review at what we call 'social history' is so important," says Dr. Nautiyal. "For instance, patients with a history of IV drug or alcohol use may be at an increased risk for certain cancers. East Asian people may be at a higher risk for gastric and esophageal cancers. Colon and rectal cancers are becoming more common in American and Western culture, probably because of diet and lifestyle."

According to the American Cancer Society, excluding non-melanoma skin cancer, at least 42% of newly diagnosed cancers in the U.S. are potentially avoidable. The factors known to contribute to an increased risk of cancer include but are certainly not limited to:

• Cigarette smoking
• Alcohol consumption
• Excess body weight
• Physical inactivity
• Unhealthy diet
• Lack of vaccination against HPV
• Excess sun exposure or tanning

(Related: 8 Ways to Reduce Your Cancer Risk)

What happens if my screening results are abnormal?

As mentioned with breast and prostate cancer, an abnormal screening result doesn't necessarily mean you automatically have cancer. Instead, Dr. Nautiyal says your primary care doctor will be able to order additional testing if your results are abnormal. By the time a patient sees an oncologist, their primary care doctor will have likely made a diagnosis, but there are "confusing" cases with "gray areas" where the PCP will contact an oncologist.

"In those cases, the primary care doctor, especially through Houston Methodist, will reach out to me. I may get involved before a diagnosis in certain cases, but usually the primary care doctor is going to be initiating testing," he says.

Don't let fear stop you from getting screened

Cancer screening saves lives. Plain and simple. But the decision to get checked and take preventative measures is understandably not so cut-and-dry. In parting, Dr. Nautiyal says this:

It's one thing to ignore high blood pressure. You could ignore that for many years before it causes problems. If you have colon or breast cancer and ignore it, there's really no way out, and you will end up becoming more sick and coming to see me at a much sicker state.

The improvements in treatment for higher-staged cancers have been marginal over the past couple of decades, and when you look how cancer mortality rates have been going down, that's not because there are new drugs that have reduced the mortality by that much. It's because we have been reducing smoking, increasing cancer screening, finding cancers at earlier stages or preventing them altogether.

All that to say, dealing with one's own anxiety about medical care is so important because you can't ignore it, and we may not be able to help you in a way that we could have when it's earlier on in the disease course.

It's worth talking with your doctor about it — say, you have a phobia of colonoscopies. There are other noninvasive screening mechanisms, like having a stool sample tested. People may not know there are less invasive or alternative screening mechanisms. I would not let a fear about a particular screening prevent you from having the proper discussions and getting the care you need.

There are ways we can help. You just have to let us try to help you.