Cancer screening is looking for cancer at an early stage before a person has any symptoms. It can be a key factor in being able to survive cancer. When abnormal tissue or cancer is found early, it may be easier to treat or cure. Read more about the benefits and risks of cancer screening tests.
Risks of Prostate Cancer Screening
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What Is Cancer Screening?
Screening for Cancer
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Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations Breast cancer
Mammography: Women 40 and older should have a mammogram every year.
Clinical breast exam (breast exam performed by a medical professional): Women age 20-40 should have one every 3 years. Women 40 and older should have one every year.
Breast self-exam: Women age 20 and older should perform one each month (considered optional).
If you have a family history of breast cancer, talk to your healthcare professional about what type of screening you should have, and how often.
Image by TheVisualMD
What Is Cancer Screening?
Cancer screening is looking for cancer before a person has any symptoms.
Screening tests can help find cancer at an early stage, before symptoms appear. When abnormal tissue or cancer is found early, it may be easier to treat or cure. By the time symptoms appear, the cancer may have grown and spread. This can make the cancer harder to treat or cure.
It is important to remember that when your doctor suggests a screening test, it does not always mean he or she thinks you have cancer. Screening tests are done when you have no cancer symptoms.
There are different kinds of screening tests.
Screening tests include the following:
Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body.
Imaging procedures: Procedures that make pictures of areas inside the body.
Genetic tests: A laboratory test in which cells or tissue are analyzed to look for changes in genes or chromosomes. These changes may be a sign that a person has or is at risk of having a specific disease or condition.
Screening tests have risks.
Not all screening tests are helpful and most have risks. It is important to know the risks of the test and whether it has been proven to decrease the chance of dying from cancer.
Some screening tests can cause serious problems.
Some screening procedures can cause bleeding or other problems. For example, colon cancer screening with sigmoidoscopy or colonoscopy can cause tears in the lining of the colon.
False-positive test results are possible.
Screening test results may appear to be abnormal even though there is no cancer. A false-positive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by more tests and procedures, which also have risks.
False-negative test results are possible.
Screening test results may appear to be normal even though there is cancer. A person who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if there are symptoms.
Finding the cancer may not improve the person's health or help the person live longer.
Some cancers never cause symptoms or become life-threatening, but if found by a screening test, the cancer may be treated. There is no way to know if treating the cancer would help the person live longer than if no treatment were given. In both teenagers and adults, there is a rare risk of attempted or actual suicide in the first year after being diagnosed with cancer. Also, treatments for cancer have side effects.
For some cancers, finding and treating the cancer early does not improve the chance of a cure or help the person live longer.
Source: National Cancer Institute (NCI)
Additional Materials (12)
Colorectal Cancer Screening & Diagnosis
Colorectal cancer includes cancer of both the colon and rectum. It is the fourth most common cancer in the United States and the second leading cause of cancer-related deaths affecting both men and women equally. The CDC recommends that everyone age 50 or over be screened. When diagnosed early, patients have a 90% 5-year survival rate.
Image by TheVisualMD
DNA Methylation
NIH researchers have identified a DNA methylation signature in tumor DNA common to five types of cancer. The signature results from a chemical modification of DNA called methylation, which can control the expression of genes like a dimmer on a light switch. They hope this finding will spur development of a blood test that can be used to diagnose a variety of cancers at early stages.
Image by Darryl Leja, NHGRI Image Gallery
What you need to know about cancer screenings
Video by Michigan Medicine/YouTube
Colorectal Cancer Screening: Colonoscopy Saves Lives
Video by Roswell Park Comprehensive Cancer Center/YouTube
How to do the bowel cancer screening test
Video by Cancer Research UK/YouTube
Breast Cancer in Women of Color: Controversies in Breast Cancer Screening
Video by NYU Langone Health/YouTube
Deeper Dive on PSA Screening
Video by DocMikeEvans/YouTube
CreationVideo.com | NHS Breast Screening: It's Your Choice - 1
Video by CreationVideo | Video Production + Live Streaming/YouTube
NHS Cervical Cancer Screening Module 1
Video by ASKVisualScience/YouTube
NHS Cervical Cancer Screening Module 2
Video by ASKVisualScience/YouTube
NHS Cervical Cancer Screening Module 3
Video by ASKVisualScience/YouTube
Cervical Cancer Screening Module 4
Video by ASKVisualScience/YouTube
Colorectal Cancer Screening & Diagnosis
TheVisualMD
DNA Methylation
Darryl Leja, NHGRI Image Gallery
2:46
What you need to know about cancer screenings
Michigan Medicine/YouTube
1:14
Colorectal Cancer Screening: Colonoscopy Saves Lives
Roswell Park Comprehensive Cancer Center/YouTube
2:23
How to do the bowel cancer screening test
Cancer Research UK/YouTube
16:02
Breast Cancer in Women of Color: Controversies in Breast Cancer Screening
NYU Langone Health/YouTube
1:57
Deeper Dive on PSA Screening
DocMikeEvans/YouTube
6:28
CreationVideo.com | NHS Breast Screening: It's Your Choice - 1
CreationVideo | Video Production + Live Streaming/YouTube
1:33
NHS Cervical Cancer Screening Module 1
ASKVisualScience/YouTube
1:45
NHS Cervical Cancer Screening Module 2
ASKVisualScience/YouTube
2:11
NHS Cervical Cancer Screening Module 3
ASKVisualScience/YouTube
1:26
Cervical Cancer Screening Module 4
ASKVisualScience/YouTube
Informed and Shared Decision-Making
Screening for Cancer, cancer screening
Image by TheVisualMD
Screening for Cancer, cancer screening
Image by TheVisualMD
What Is Informed and Shared Decision-Making?
It is important that you understand the benefits and harms of screening tests and make an informed choice about which screening tests are right for you.
Before having any screening test, it is important that you discuss the test with your doctor or other health care provider. Every screening test has both benefits and harms. Your health care provider should talk to you about the benefits and harms of a screening test and include you in the decision about whether the screening test is right for you. This is called informed and shared decision-making.
Your health care provider will talk to you about the possible benefits, harms, and unknowns of a screening test. This may include information about the benefits of finding a cancer early or the harms related to false test results, overdiagnosis, and overtreatment. Your health care provider may also give you information in a leaflet, booklet, video, website, or other material.
After you understand the benefits and harms of a screening test, you can decide whether or not you want to have the screening test based on what is best for you. Sometimes the harms and benefits are closely matched and the decision about whether to have a screening test is hard to make.
Your health care provider will write your decision down in your medical record and order the screening test, if that was your decision.
Source: National Cancer Institute (NCI)
Additional Materials (7)
Shared decision making
Video by Osmosis/YouTube
What is informed consent?
Video by Royal College of Dental Surgeons of Ontario/YouTube
What is Informed Consent?
Video by Genentech/YouTube
What is Informed Consent? | Kaiser Permanente
Video by Kaiser Permanente Thrive/YouTube
Understanding Informed Consent
Video by National Human Genome Research Institute/YouTube
Understanding Consent
Video by Teaching Sexual Health Alberta Health Services/YouTube
Breast Cancer Surgery: How to Make an Informed Decision
Video by Breastcancer.org/YouTube
3:47
Shared decision making
Osmosis/YouTube
2:27
What is informed consent?
Royal College of Dental Surgeons of Ontario/YouTube
6:10
What is Informed Consent?
Genentech/YouTube
1:51
What is Informed Consent? | Kaiser Permanente
Kaiser Permanente Thrive/YouTube
10:48
Understanding Informed Consent
National Human Genome Research Institute/YouTube
3:03
Understanding Consent
Teaching Sexual Health Alberta Health Services/YouTube
50:59
Breast Cancer Surgery: How to Make an Informed Decision
Breastcancer.org/YouTube
Goals of Screening Tests
Colon Polyp removal - Colonic polypectomy
Image by TheVisualMD
Colon Polyp removal - Colonic polypectomy
Colon Polyp removal - Colonic polypectomy
Image by TheVisualMD
What Are the Goals of Screening Tests?
Screening tests have many goals.
A screening test that works the way it should and is helpful does the following:
Finds cancer before symptoms appear.
Screens for a cancer that is easier to treat and cure when found early.
Has few false-negative test results and false-positive test results.
Decreases the chance of dying from cancer.
Screening tests are not meant to diagnose cancer.
Screening tests usually do not diagnose cancer. If a screening test result is abnormal, more tests may be done to check for cancer. For example, a screening mammogram may find a lump in the breast. A lump may be cancer or something else. More tests need to be done to find out if the lump is cancer. These are called diagnostic tests. Diagnostic tests may include a biopsy, in which cells or tissues are removed so a pathologist can check them under a microscope for signs of cancer.
Source: National Cancer Institute (NCI)
Additional Materials (8)
Polyp removal
Drawing of a colon polyp being removed by a colonoscope with labels pointing to the polyp, colonoscope, and two intestinal folds. The wire loop at the end of the colonoscope is around the base of the polyp.
Image by NIDDK Image Library
Polyp Embedded in Colon
Most cancer in the colon and rectum begins in polyps, tissue masses that grow out of the intestinal wall. Polyps grow slowly and most are benign, but they may become cancerous over time. When a polyp becomes cancerous, it starts to invade the intestinal wall and may spread into nearby lymph nodes or capillaries. From there the cancerous cells can enter into the lymphatic system or the bloodstream and metastasize, spreading to areas distant from the original site. There they may form new tumors.
Image by TheVisualMD
Health Screenings, When & Why?
Video by CNN/YouTube
Ovarian Cancer Screening: What You Need to Know Following the FDA's Alert
Video by Roswell Park Comprehensive Cancer Center/YouTube
Breast Cancer Screening and Symptoms
Video by Cancer Treatment Centers of America - CTCA/YouTube
NHS Prostate Cancer Screening Module 2
Video by AS&K Communications - Visual Science/YouTube
NHS Breast Cancer Screening - Module 1
Video by ASKVisualScience/YouTube
2015 Breast Cancer Screening Recommendations for Women at Average Risk
Video by JAMA Network/YouTube
Polyp removal
NIDDK Image Library
Polyp Embedded in Colon
TheVisualMD
2:41
Health Screenings, When & Why?
CNN/YouTube
1:27
Ovarian Cancer Screening: What You Need to Know Following the FDA's Alert
Roswell Park Comprehensive Cancer Center/YouTube
1:00
Breast Cancer Screening and Symptoms
Cancer Treatment Centers of America - CTCA/YouTube
1:34
NHS Prostate Cancer Screening Module 2
AS&K Communications - Visual Science/YouTube
2:07
NHS Breast Cancer Screening - Module 1
ASKVisualScience/YouTube
4:28
2015 Breast Cancer Screening Recommendations for Women at Average Risk
JAMA Network/YouTube
Who Needs Screening?
Inheritance and Family Medical History
Image by mcmurryjulie
Inheritance and Family Medical History
Family History
Image by mcmurryjulie
Who Needs to Be Screened?
Certain screening tests may be suggested only for people who have a high risk for certain cancers.
Anything that increases the chance of cancer is called a cancer risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer.
Some screening tests are used only for people who have known risk factors for certain types of cancer. People known to have a higher risk of cancer than others include those who have any of the following:
A personal history of cancer.
A family history of cancer.
Certain gene mutations (changes) that have been linked to cancer.
Exposure to cancer-causing agents such as tobacco smoke or workplace chemicals.
A blood clot that develops for no known reason.
Older age.
People who have a high risk of cancer may need to be screened more often or at an earlier age than other people.
Cancer screening research includes finding out who has an increased risk of cancer.
Scientists are trying to better understand who is likely to get certain types of cancer. They study the things we do and the things around us to see if they cause cancer. This information helps doctors figure out who should be screened for cancer, which screening tests should be used, and how often the tests should be done.
Since 1973, the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute has been collecting information on people with cancer from different parts of the United States. Information from SEER, research studies, and other sources is used to study who is at risk.
Source: National Cancer Institute (NCI)
Additional Materials (14)
Screenshot of the My Family Health Portrait website
Screenshot of the My Family Health Portrait website
Knowing your family’s health history can help your health care team provide better care for you.
Image by NIH News in Health
Family history (medicine)
A large family having fun by the water.
Image by Evil Erin
Family history (medicine)
Image by Daniel Morin
Family history (medicine)
An extended family in Spain
Image by Ojedamd
Cancer & Me: Screening
Video by NYGHNews/YouTube
Screening for Colorectal Cancer
Video by Dartmouth-Hitchcock/YouTube
3D Medical Animation, NHS Bowel Cancer Screening ( physician's module 3 )
Video by ASKVisualScience/YouTube
NHS Bowel Cancer Screening - It's Your Choice | part 1
Video by CreationVideo | Video Production + Live Streaming/YouTube
PSA Test: Prostate Cancer Screening Harmful to Men?
Video by ABC News/YouTube
Colon Cancer: At-Home Screening with Stool-Based Testing
Video by uvahealth/YouTube
Lung Cancer Screening: The Life-saving CT Scan
Video by RAYUS Radiology™/YouTube
Breast cancer screening | NHS
Video by NHS/YouTube
What Is Bowel Cancer? | At Home Bowel Screening
Video by LetsGetChecked/YouTube
The Future of Cancer Screening: Public Health Approaches
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Screenshot of the My Family Health Portrait website
NIH News in Health
Family history (medicine)
Evil Erin
Family history (medicine)
Daniel Morin
Family history (medicine)
Ojedamd
7:21
Cancer & Me: Screening
NYGHNews/YouTube
4:06
Screening for Colorectal Cancer
Dartmouth-Hitchcock/YouTube
1:40
3D Medical Animation, NHS Bowel Cancer Screening ( physician's module 3 )
ASKVisualScience/YouTube
6:50
NHS Bowel Cancer Screening - It's Your Choice | part 1
CreationVideo | Video Production + Live Streaming/YouTube
3:22
PSA Test: Prostate Cancer Screening Harmful to Men?
ABC News/YouTube
2:49
Colon Cancer: At-Home Screening with Stool-Based Testing
uvahealth/YouTube
3:09
Lung Cancer Screening: The Life-saving CT Scan
RAYUS Radiology™/YouTube
3:47
Breast cancer screening | NHS
NHS/YouTube
3:39
What Is Bowel Cancer? | At Home Bowel Screening
LetsGetChecked/YouTube
4:53
The Future of Cancer Screening: Public Health Approaches
Centers for Disease Control and Prevention (CDC)/YouTube
How Is Risk Measured?
Odds ratio map
Image by Skbkekas/Wikimedia
Odds ratio map
Map showing how the log odds ratio relates to the probability of the outcome in two groups.
Image by Skbkekas/Wikimedia
How Is Cancer Risk Measured?
Cancer risk is measured in different ways. The findings from surveys and studies about cancer risk are studied and the results are explained in different ways. Some of the ways risk is explained include absolute risk, relative risk, and odds ratios.
Absolute risk
This is the risk a person has of developing a disease, in a given population (for example, the entire U.S. population) over a certain period of time. Researchers estimate the absolute risk by studying a large number of people that are part of a certain population (for example, women in a given age group). Researchers count the number of people in the group who get a certain disease over a certain period of time. For example, a group of 100,000 women between the ages of 20 and 29 are observed for one year, and 4 of them get breast cancerduring that time. This means that the one-year absolute risk of breast cancer for a woman in this age group is 4 in 100,000, or 4 chances in 100,000.
Relative risk
This is often used in research studies to find out whether a trait or a factor can be linked to the risk of a disease. Researchers compare two groups of people who are a lot alike. However, the people in one of the groups must have the trait or factor being studied (they have been “exposed”). The people in the other group do not have it (they have not been exposed). To figure out relative risk, the percentage of people in the exposed group who have the disease is divided by the percentage of people in the unexposed group who have the disease.
Relative risks can be:
Larger than 1: The trait or factor is linked to an increase in risk.
Equal to 1: The trait or factor is not linked to risk.
Less than 1: The trait or factor is linked to a decrease in risk.
Relative risks are also called risk ratios.
Odds ratio
In some types of studies, researchers don’t have enough information to figure out relative risks. They use something called an odds ratio instead. An odds ratio can be an estimate of relative risk.
One type of study that uses an odds ratio instead of relative risk is called a case-control study. In a case-control study, two groups of people are compared. However, the individuals in each group are chosen based on whether or not they have a certain disease. Researchers look at the odds that the people in each group were exposed to something (a trait or factor) that might have caused the disease. Odds describes the number of times the trait or factor was present or happened, divided by the number of times it wasn’t present or didn’t happen. To get an odds ratio, the odds for one group are divided by the odds for the other group.
Odds ratios can be:
Larger than 1: The trait or factor is linked to an increase in risk.
Equal to 1: The trait or factor is not linked to risk.
Less than 1: The trait or factor is linked to a decrease in risk.
Looking at traits and exposures in people with and without cancer can help find possible risk factors. Knowing who is at an increased risk for certain types of cancer can help doctors decide when and how often they should be screened.
Source: National Cancer Institute (NCI)
Additional Materials (9)
Preventive Medicine Statistics Sensitivity TPR, Specificity TNR, PPV, NPV, FDR, FOR, ACCuracy, Likelihood Ratio, Diagnostic Odds Ratio 2 Final
Confusion matrix
Table of Confusion
Image by Lavender888000/Wikimedia
Risk Factors for Cancer | Did You Know?
Video by National Cancer Institute/YouTube
How much does alcohol affect breast cancer risk?
Video by Breast Cancer Now/YouTube
Does Atypical Hyperplasia Increase Breast Cancer Risk?
Video by Breast Cancer Answers®/YouTube
Fibroadenoma Definition And Cancer Risk
Video by Breast Cancer Answers®/YouTube
Testicular Cancer Risk Factors | Testicular Cancer
Video by Howcast/YouTube
Hepatitis C and Other Risk Factors for Liver Cancer
Video by Roswell Park Comprehensive Cancer Center/YouTube
Understanding BRCA 1/2 Cancer Risk | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
Why Am I at Risk of Developing Breast Cancer? | Being Jewish and Breast Cancer Risk
Video by Johns Hopkins Medicine/YouTube
Preventive Medicine Statistics Sensitivity TPR, Specificity TNR, PPV, NPV, FDR, FOR, ACCuracy, Likelihood Ratio, Diagnostic Odds Ratio 2 Final
Lavender888000/Wikimedia
5:11
Risk Factors for Cancer | Did You Know?
National Cancer Institute/YouTube
1:24
How much does alcohol affect breast cancer risk?
Breast Cancer Now/YouTube
4:53
Does Atypical Hyperplasia Increase Breast Cancer Risk?
Breast Cancer Answers®/YouTube
4:54
Fibroadenoma Definition And Cancer Risk
Breast Cancer Answers®/YouTube
1:01
Testicular Cancer Risk Factors | Testicular Cancer
Howcast/YouTube
2:01
Hepatitis C and Other Risk Factors for Liver Cancer
Roswell Park Comprehensive Cancer Center/YouTube
35:40
Understanding BRCA 1/2 Cancer Risk | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
3:36
Why Am I at Risk of Developing Breast Cancer? | Being Jewish and Breast Cancer Risk
Johns Hopkins Medicine/YouTube
Does Screening Help Live Longer?
Population Architecture Using Genomics and Epidemiology (PAGE)
Image by NHGRI Image Gallery/Credit: Jonathan Bailey, NHGRI.
Population Architecture Using Genomics and Epidemiology (PAGE)
Through NHGRI's Population Architecture Using Genomics and Epidemiology (PAGE) program, five research teams in 2013 have received new four-year awards to study the genomics of disease susceptibility in ethnically diverse populations.
Image by NHGRI Image Gallery/Credit: Jonathan Bailey, NHGRI.
Does Screening Help People Live Longer?
Finding some cancers at an early stage (before symptoms appear) may help decrease the chance of dying from those cancers.
For many cancers, the chance of recovery depends on the stage (the amount or spread of cancer in the body) of the cancer when it was diagnosed. Cancers that are diagnosed at earlier stages are often easier to treat or cure.
Studies of cancer screening compare the death rate of people screened for a certain cancer with the death rate from that cancer in people who were not screened. Some screening tests have been shown to be helpful both in finding cancers early and in decreasing the chance of dying from those cancers. These include mammograms for breast cancer and sigmoidoscopy and fecal occult blood testing for colorectal cancer. Other tests are used because they have been shown to find a certain type of cancer in some people before symptoms appear, but they have not been proven to decrease the risk of dying from that cancer. If a cancer is fast-growing and spreads quickly, finding it early may not help the person survive the cancer.
Screening studies are done to see whether deaths from cancer decrease when people are screened.
When collecting information on how long cancer patients live, some studies define survival as living 5 years after the diagnosis. This is often used to measure how well cancer treatments work. However, to see if screening tests are useful, studies usually look at whether deaths from the cancer decrease in people who were screened. Over time, signs that a cancer screening test is working include:
An increase in the number of early-stage cancers found.
A decrease in the number of late-stage cancers found.
A decrease in the number of deaths from the cancer.
The number of deaths from cancer is lower today than it was in the past. It is not always clear if this is because screening tests found the cancers earlier or because cancer treatments have gotten better, or both. The Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute collects and reports information on survival times of people with cancer in the United States. This information is studied to see if finding cancer early affects how long these people live.
Certain factors may cause survival times to look like they are getting better when they are not.
These factors include lead-time bias and overdiagnosis.
Lead-time bias
Survival time for cancer patients is usually measured from the day the cancer is diagnosed until the day they die. Patients are often diagnosed after they have signs and symptoms of cancer. If a screening test leads to a diagnosis before a patient has any symptoms, the patient’s survival time is increased because the date of diagnosis is earlier. This increase in survival time makes it seem as though screened patients are living longer when that may not be happening. This is called lead-time bias. It could be that the only reason the survival time appears to be longer is that the date of diagnosis is earlier for the screened patients. But the screened patients may die at the same time they would have without the screening test.
Overdiagnosis
Sometimes, screening tests find cancers that don't matter because they would have gone away on their own or never caused any symptoms. These cancers would never have been found if not for the screening test. Finding these cancers is called overdiagnosis. Overdiagnosis can make it seem like more people are surviving cancer longer, but in reality, these are people who would not have died from cancer anyway.
Source: National Cancer Institute (NCI)
Additional Materials (10)
Lung Cancer Screening: Early Detection for Smokers
Video by uvahealth/YouTube
Understanding Prognosis: For Doctors, a Patient-Centered Approach
Video by National Cancer Institute/YouTube
Deeper Dive on PSA Screening
Video by DocMikeEvans/YouTube
Cervical Cancer Screening Saves Lives
Video by My Doctor - Kaiser Permanente/YouTube
Breast Cancer Screening Guidelines
Video by uvahealth/YouTube
Skin Cancer Screening Yourself - Daily Do's of Dermatology
Video by Doctorpedia/YouTube
Ovarian cancer screening test shows promise
Video by MD Anderson Cancer Center/YouTube
What's that Spot? Skin Cancer Awareness & Screening
Video by MD Anderson Cancer Center/YouTube
Colorectal Cancer Screening: What to Expect
Video by National Cancer Institute/YouTube
Ovarian Cancer Symptoms, Detection & Screening | Memorial Sloan Kettering
Video by Memorial Sloan Kettering/YouTube
2:17
Lung Cancer Screening: Early Detection for Smokers
uvahealth/YouTube
4:00
Understanding Prognosis: For Doctors, a Patient-Centered Approach
National Cancer Institute/YouTube
1:57
Deeper Dive on PSA Screening
DocMikeEvans/YouTube
3:30
Cervical Cancer Screening Saves Lives
My Doctor - Kaiser Permanente/YouTube
1:01
Breast Cancer Screening Guidelines
uvahealth/YouTube
1:40
Skin Cancer Screening Yourself - Daily Do's of Dermatology
Doctorpedia/YouTube
1:37
Ovarian cancer screening test shows promise
MD Anderson Cancer Center/YouTube
1:50
What's that Spot? Skin Cancer Awareness & Screening
MD Anderson Cancer Center/YouTube
2:40
Colorectal Cancer Screening: What to Expect
National Cancer Institute/YouTube
7:57
Ovarian Cancer Symptoms, Detection & Screening | Memorial Sloan Kettering
Memorial Sloan Kettering/YouTube
What Are Some Screening Tests?
Screening & Diagnosis
Image by TheVisualMD
Screening & Diagnosis
Image by TheVisualMD
Learn About Cancer Screening
Breast Cancer Screening
A mammogram provides an X-ray of the breast and is the best way to find breast cancer for most adults.
Who should get screened?
Women should have a cancer risk assessment done by their primary care physician at around age 35. For average risk women, the recommendations are the below.
Women 40-44 should have the opportunity to begin annual screening.
Women 45-54 should be screened annually.
Women 55+ should be screened every other year or have the opportunity to continue screening annually.
Cervical Cancer Screening
Two tests, the Pap and HPV tests, can help prevent cervical cancer. Pap tests look for cell changes on the cervix that could become cervical cancer. HPV tests look for the human papillomavirus (HPV) that can cause cells on the cervix to become cancerous. Both tests involve a pelvic examination in which a metal or plastic device, called a speculum, is inserted in the vagina to view the cervix. A small brush is then used to collect cells from the cervix.
Who should get screened?
Women should have a cancer risk assessment done by their primary care physician at around age 35. For average risk women, the recommendations are the below.
Women 21-29 should get a Pap test every 3 years
Women 30-65 should get screened every 3-5 years depending on the test chosen (Pap test alone is every 3 years; both Pap and HPV testing is every 5 years; and HPV testing alone is every 5 years)
Colorectal Cancer Screening
Colorectal cancer screenings check for abnormal growths in the colon or rectum. Following tests screen for colon cancer:
Fecal immunochemical test (FIT)
Flexible Sigmoidoscopy
Colonoscopy
FIT screening is done at home to check for blood in stool that you can't see, which can be due to polyps or cancer. If either FIT or flexible sigmoidoscopy detects an abnormality, colonoscopy is necessary. During a colonoscopy, polyps can be removed before they become cancer.
Who should get screened?
Adults aged 45-75 without any known increased risk of colorectal cancer should be screened with one of the following, based on a conversation with their primary care provider:
Home-based FIT every year
Flexible sigmoidoscopy every 5 years, or every 10 years with a FIT every year
Colonoscopy every 10 years
Lung Cancer Screening
Lung cancer screening uses a low-dose computed tomography (CT) scan to look for signs of lung cancer. This CT scan uses a low dose of x-rays to take detailed pictures of your lungs.
Who should get screened?
You may qualify if you meet these three conditions:
Are 50-80 years old
Smoke cigarettes now or quit within the past 15 years
Smoked cigarettes for at least 20 pack-years*
*A “pack-year” is an estimate of how many cigarettes you have smoked in your lifetime. 20 “pack-years” equals smoking one pack of cigarettes a day for 20 years or two packs of cigarettes a day for 10 years.
What are your next steps for cancer screening?
Talk to your primary care provider to determine whether you are due for any of the screenings listed here and ask any questions you might have.
Source: U.S. Department of Veterans Affairs
Additional Materials (27)
Cancer screening
Cancer Imaging : Imaging is used before, during, and after cancer treatment. Screening using imaging can help determine if there are abnormal areas present that may be cancerous. Imaging can be used in diagnosis and staging to find out how much cancer is in the body, where it`s located, and if it`s metastasized. During treatment, imaging can determine the exact tumor location and show if a treatment is working by showing if a tumor is shrinking or has changed. After treatment, imaging can be used to see if a cancer has recurred or metastasized elsewhere. Types of imaging used include X-rays, ultrasound, magnetic resonance imaging (MRI), computerized tomography (CT), positron emission tomography (PET), PET/CT, and single photon emission computerized tomography (SPECT).
Image by TheVisualMD
All Views
Inside
Outside
Unfurled
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Virtual Colonoscopy
Virtual colonoscopy is a new technology that uses computerized tomography (CT) images to look for polyps and cancer in the colon. The result is a computer-generated, animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy is performed for removal or biopsy of the growth.
Interactive by TheVisualMD
MRI Slices of the Prostate
Radiologists view different cross-sectional slices of the prostate, including the sagittal and axial slices, in order to detect any abnormalities.
Image by TheVisualMD
PET/CT
CT
PET
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PET/CT Scans of Colorectal Cancer 1) Pet/CT scan 2) CT Scan 3) Pet Scan
PET scans can often detect a tumor that can't be seen on CT scans or regular X-rays. Cancer tumors grow rapidly and so actively metabolize glucose. In a PET scan, the patient is injected with glucose containing a radioactive tracer. The PET scan image shows areas of the body that utilize the glucose. The brain, heart, and bladder all metabolize glucose and appear black in the image, along with any cancer tumors that are present.
Interactive by TheVisualMD
Digital Mammography
Bilateral digital mammography images of the breasts; mediolateral oblique view
Image by Nevit Dilmen (talk)
PET/CT for Prostate Cancer
The PET/CT scanner is a tool that uses two different imaging modalities to determine the spreading (metastasis) of cancer. Here, Dr. Peter Choyke, radiologist at the National Cancer Institute, shows you the machine and the advantages of each modality.
Image by TheVisualMD
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Mammography
A woman's breast being compressed to get the optimum mammographic image.
Image by National Cancer Institute / Bill Branson (Photographer)
Mammography
Image by BruceBlaus
Mammography
Mammogram being conducted
Image by CDC
Mammogram vs. MRI
Title Mammogram vs. MRI Description A mammography on left and a Magnetic resonance image (MRI) on right. Breast imaging technology has changed over the years. Note MRI's enhancement ability to confirm diagnosis.
Image by Mitchell D. Schnall, M.D., Ph.D. University Of Pennsylvania
Diagnosis of Prostate Cancer
Diagnosis of Prostate Cancer
Image by Tonry, C., Finn, S., Armstrong, J. et al./Wikimedia
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Normal (left) versus cancerous (right) mammography image.
Normal (left) versus cancerous (right) mammography image.
Image by National Cancer Institute
Genetic testing
Genetic testing fact sheet
Image by genome.gov
Lung Cancer
Chest X-ray (Cancer): This is an x-ray image of a chest. Both sides of the lungs are visible with a growth on the left side of the lung, which could possibly be lung cancer.
Image by National Cancer Institute
skin cancer test
A visual skin cancer test is conducted on a military retiree during the Retiree Appreciation Day at Marston Pavilion aboard Marine Corps Base Camp Lejeune, Sept. 18. The event featured a Naval Hospital Camp Lejeune health and wellness fair, which had free medical testing services ranging from blood pressure checks to skin cancer screenings to proper nutrition information.
Image by Lance CPl. Jonathan G. Wright
Lung Cancer
Three-dimensional (3D) CT with volume rendering of a male's thorax shows a tumor in the peripheral airway of the left lung.
Image by Lange123 at German Wikipedia
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Pap Test: Pap Smear (Pap Test)
A Pap smear, also called a Pap test, is a procedure to test for cervical cancer as well as a number of different types of infections. The test involves collecting cells from the cervix. A speculum is inserted into the vagina, and samples of cervical cells are collected and examined under a microscope for abnormalities. Detecting cervical cancer early with a Pap smear gives women a greater chance of being cured. A Pap smear can also detect changes in cervical cells that suggest cancer may develop in the future. The Pap smear is usually done in conjunction with a pelvic exam. In women over 30, the Pap smear may be combined with a test for human papillomavirus (HPV), a common sexually transmitted infection that may cause cervical cancer in some women.
Image by TheVisualMD
Breast MRI without contrast agent gadolinium is injected B&W 01
Breast MRI without contrast agent gadolinium is injected B&W 04
Breast MRI with contrast agent gadolinium is injected 01
Breast MRI with contrast agent gadolinium is injected 02
Breast MRI with contrast agent gadolinium is injected 03
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Breast MRI_with_contrast agent gadolinium is injected
A standard breast MRI image is taken for reference before the contrast agent gadolinium is injected. Gadolinium causes cancerous tissue to rapidly brighten in the MRI image about a minute after injection. It also quickly washes out of tumors faster than from normal tissue. Radiologists watch for the rapid brightening and washout in a series of MRI images taken roughly 1 minute apart.
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Breast MRI 01 contrast agent gadolinium is injected
Breast MRI 02 contrast agent gadolinium is injected
Breast MRI 03 contrast agent gadolinium is injected
Breast MRI 04 contrast agent gadolinium is injected
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Breast MRI_contrast agent gadolinium is injected
A standard breast MRI image is taken for reference before the contrast agent gadolinium is injected. Gadolinium causes cancerous tissue to rapidly brighten in the MRI image about a minute after injection. It also quickly washes out of tumors faster than from normal tissue. Radiologists watch for the rapid brightening and washout in a series of MRI images taken roughly 1 minute apart.
Interactive by TheVisualMD
Low magnification micrograph of a Wilms' tumour, also nephroblastoma and Wilms tumour. Surgical excision.
Intermediate magnification micrograph of a Wilms' tumour, also nephroblastoma and Wilms tumour.
High magnification micrograph of a Wilms' tumour, also nephroblastoma and Wilms tumour. Surgical excision.
Very high magnification micrograph of a Wilms' tumour, also nephroblastoma and Wilms tumour. Surgical excision. H&E stain. Wilms tumour is a type of kidney cancer that is seen predominantly in children.
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Wilms' tumor - Nephroblastoma
Micrographs of a Wilms' tumour, also nephroblastoma and Wilms tumour. Surgical excision. H&E stain. Wilms tumour is a type of kidney cancer that is seen predominantly in children.
Interactive by Nephron
Breast Self-Exam
Breast Self-Exam
Breast Self-Exam
Breast Self-Exam
Breast Self-Exam
Breast Self-Exam
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Breast Self-Exam
Breast self-exam (BSE) saves lives. Women who perform BSE are more likely to be diagnosed with smaller tumors, and cancer is less likely to have spread to their underarm lymph nodes. BSE helps women to be aware of what their breasts normally feel and look like so that they notice any changes.
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X-ray computed tomography 1
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X-ray computed tomography - CT Slices of the Abdomen
CT Scan - CT Slices of the Abdomen
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Stage 0
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Breast Cancer Summary Staging
After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body.
Interactive by TheVisualMD
Lymph Node Biopsy
Lymph Node Biopsy
Lymph Node Biopsy
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Breast Cancer - Lymph Node Biopsy
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
Interactive by TheVisualMD
Breast Anatomy With Cancer (Nipple)
Breast Anatomy With Cancer (Breast Tissue)
Breast Anatomy With Cancer (Fat)
Breast Anatomy With Cancer (Suspensory Ligaments)
Breast Anatomy With Cancer (Ducts)
Breast Anatomy With Cancer (Chest Wall Muscle)
Breast Anatomy With Cancer (Ribs)
Breast Anatomy With Cancer (Tumor)
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Breast Anatomy with Cancer
Structures of the breast with cancer are visible in a Breast MRI: Nipple, Breast tissue, Fat, Suspensory ligaments, Ducts, Chest wall muscle, Ribs, Tumor
Interactive by TheVisualMD
Healthy Cervix / Cervix with Cervical Cancer
Healthy Cervix vs Cervix with Cervical Cancer
Interactive by Haeok Lee1,2*, Mary Sue Makin3, Jasintha T Mtengezo4,5 and Address Malata6 / Wikimedia Commons
Tracking cancer with a blood test
Video by Cancer Research UK/YouTube
Cancer screening
TheVisualMD
Virtual Colonoscopy
TheVisualMD
MRI Slices of the Prostate
TheVisualMD
PET/CT Scans of Colorectal Cancer 1) Pet/CT scan 2) CT Scan 3) Pet Scan
TheVisualMD
Digital Mammography
Nevit Dilmen (talk)
PET/CT for Prostate Cancer
TheVisualMD
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Mammography
National Cancer Institute / Bill Branson (Photographer)
Mammography
BruceBlaus
Mammography
CDC
Mammogram vs. MRI
Mitchell D. Schnall, M.D., Ph.D. University Of Pennsylvania
Diagnosis of Prostate Cancer
Tonry, C., Finn, S., Armstrong, J. et al./Wikimedia
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Normal (left) versus cancerous (right) mammography image.
National Cancer Institute
Genetic testing
genome.gov
Lung Cancer
National Cancer Institute
skin cancer test
Lance CPl. Jonathan G. Wright
Lung Cancer
Lange123 at German Wikipedia
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Pap Test: Pap Smear (Pap Test)
TheVisualMD
Breast MRI_with_contrast agent gadolinium is injected
TheVisualMD
Breast MRI_contrast agent gadolinium is injected
TheVisualMD
Wilms' tumor - Nephroblastoma
Nephron
Breast Self-Exam
TheVisualMD
X-ray computed tomography - CT Slices of the Abdomen
TheVisualMD
Breast Cancer Summary Staging
TheVisualMD
Breast Cancer - Lymph Node Biopsy
TheVisualMD
Breast Anatomy with Cancer
TheVisualMD
Healthy Cervix vs Cervix with Cervical Cancer
Haeok Lee1,2*, Mary Sue Makin3, Jasintha T Mtengezo4,5 and Address Malata6 / Wikimedia Commons
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Tracking cancer with a blood test
Cancer Research UK/YouTube
Mammogram
Mammogram
Also called: Breast Cancer Screening - Mammography, Screening Mammography, Diagnostic Mammography
A mammogram is a low-dose x-ray picture of the breast. A mammogram is used to look for early signs of breast cancer. Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt.
Mammogram
Also called: Breast Cancer Screening - Mammography, Screening Mammography, Diagnostic Mammography
A mammogram is a low-dose x-ray picture of the breast. A mammogram is used to look for early signs of breast cancer. Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt.
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Use the slider below to see how your results affect your
health.
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Your result is Negative.
This score confirms that your mammogram results are negative, indicating that the breast tissue shows no signs of a mass or calcifications. However, it’s important to continue regular screening mammograms.
Related conditions
A mammogram is a low-dose x-ray exam of the breasts to look for changes that are not normal. The results are recorded on x-ray film or directly into a computer for a doctor called a radiologist to examine.
A mammogram allows the doctor to have a closer look for changes in breast tissue that cannot be felt during a breast exam. It is used for women who have no breast complaints and for women who have breast symptoms, such as a change in the shape or size of a breast, a lump, nipple discharge, or pain. Breast changes occur in almost all women. In fact, most of these changes are not cancer and are called "benign," but only a doctor can know for sure. Breast changes can also happen monthly, due to your menstrual period.
Screening mammograms are done for women who have no symptoms of breast cancer. It usually involves two x-rays of each breast. Screening mammograms can detect lumps or tumors that cannot be felt. They can also find microcalcifications or tiny deposits of calcium in the breast, which sometimes mean that breast cancer is present.
Diagnostic mammograms are used to check for breast cancer after a lump or other symptom or sign of breast cancer has been found. Signs of breast cancer may include pain, thickened skin on the breast, nipple discharge, or a change in breast size or shape. This type of mammogram also can be used to find out more about breast changes found on a screening mammogram, or to view breast tissue that is hard to see on a screening mammogram. A diagnostic mammogram takes longer than a screening mammogram because it involves more x-rays in order to obtain views of the breast from several angles. The technician can magnify a problem area to make a more detailed picture, which helps the doctor make a correct diagnosis.
A digital mammogram also uses x-rays to produce an image of the breast, but instead of storing the image directly on film, the image is stored directly on a computer. This allows the recorded image to be magnified for the doctor to take a closer look. Current research has not shown that digital images are better at showing cancer than x-ray film images in general. But, women with dense breasts who are pre- or perimenopausal, or who are younger than age 50, may benefit from having a digital rather than a film mammogram. Digital mammography may offer these benefits:
Long-distance consultations with other doctors may be easier because the images can be shared by computer.
Slight differences between normal and abnormal tissues may be more easily noted.
The number of follow-up tests needed may be fewer.
Fewer repeat images may be needed, reducing exposure to radiation.
A mammogram is a low-dose x-ray exam of the breasts to look for changes that are not normal. A mammogram allows the doctor to have a closer look for changes in breast tissue that cannot be felt during a breast exam. Women ages 50 to 74 years should get a mammogram every 2 years. Women younger than age 50 should talk to a doctor about when to start and how often to have a mammogram.
Mammograms can not find all problems. So, every woman should work with her doctor to check her breasts. Call your doctor or clinic if you notice any change in your breasts like:
a lump
thickening
liquid leaking from the nipple or changes in how the nipple looks
You will need to take off your shirt and bra and stand in front of a special x-ray machine. The person who takes the x-rays, called a radiologic technician, places your breasts, one at a time, between an x-ray plate and a plastic plate. These plates are attached to the x-ray machine and compress the breasts to flatten them. This spreads the breast tissue out to obtain a clearer picture. You will feel pressure on your breast for a few seconds. It may cause you some discomfort; you might feel squeezed or pinched. This feeling only lasts for a few seconds, and the flatter your breast, the better the picture. Most often, two pictures are taken of each breast — one from the side and one from above. A screening mammogram takes about 20 minutes from start to finish.
First, check with the place you are having the mammogram for any special instructions you may need to follow before you go. Here are some general guidelines to follow:
If you are still having menstrual periods, try to avoid making your mammogram appointment during the week before your period. Your breasts will be less tender and swollen. The mammogram will hurt less and the picture will be better.
If you have breast implants, be sure to tell your mammography facility that you have them when you make your appointment.
Wear a shirt with shorts, pants, or a skirt. This way, you can undress from the waist up and leave your shorts, pants, or skirt on when you get your mammogram.
Don't wear any deodorant, perfume, lotion, or powder under your arms or on your breasts on the day of your mammogram appointment. These things can make shadows show up on your mammogram.
If you have had mammograms at another facility, have those x-ray films sent to the new facility so that they can be compared to the new films.
Tell the clinic if you have physical disabilities that may make it hard for you to sit up, lift your arms, or hold your breath.
Talk with the staff about how they will handle issues of modesty that you may have due to your religion.
Because mammography uses x-rays to produce images of the breast, patients are exposed to a small amount of ionizing radiation. For most women, the benefits of regular mammograms outweigh the risks posed by this amount of radiation. The risk associated with this dose appears to be greater among younger women (under age 40). However, in some cases, the benefits of using mammography to detect breast cancer under age 40 may outweigh the risks of radiation exposure. For example, a mammogram may reveal that a suspicious mass is benign and, therefore, doesn’t need to be treated. Additionally, if a tumor is malignant and is caught early by mammogram, a surgeon may be able to remove it before it spreads and requires more aggressive treatment such as chemotherapy.
Routine screening mammography is not done during pregnancy or while breastfeeding.
You will usually get the results within a few weeks, although it depends on the facility. A radiologist reads your mammogram and then reports the results to you and your doctor. If there is a concern, you will hear from the mammography facility earlier. Contact your health care provider or the mammography facility if you do not receive a report of your results within 30 days.
Breast tissue that shows no signs of a mass or calcifications is considered normal. Most abnormal findings on a screening mammogram turn out to be benign (not cancer) or nothing to worry about. New findings or changes must be further evaluated.
What can mammograms show?
The radiologist will look at your x-rays for breast changes that do not look normal and for differences in each breast. He or she will compare your past mammograms with your most recent one to check for changes. The doctor will also look for lumps and calcifications.
Possible mammogram findings include:
Lumps (mass or tumor). Lumps come in different sizes and shapes. Fluid-filled cysts are usually smooth and rounded, with clear, defined edges and are not cancer. Lumps that have a jagged outline and an irregular shape are of more concern.
Calcifications. There are two types of breast calcifications, or calcium deposits:
Macrocalcifications, which look like small white dots on a mammogram. They are often caused by aging, an old injury, or inflammation and are usually benign.
Microcalcifications, which look like white specks on a mammogram. If found in an area of rapidly dividing cells or grouped together in a certain way, they may be a sign of DCIS or breast cancer.
Dense breast tissue: A dense breast has relatively less fat and more glandular and connective tissue. This mammogram finding is both common and normal, especially among younger women and women who use menopausal hormone therapy. Dense breast tissue can make a mammogram more difficult to interpret because both dense breast tissue and breast tumors appear as solid white areas in the image.
What happens if my mammogram is normal?
Continue to get mammograms according to recommended time intervals. Mammograms work best when they can be compared with previous ones. This allows the radiologist to compare them to look for changes in your breasts.
What happens if my mammogram is abnormal?
An abnormal mammogram does not always mean that there is cancer. But you will need to have additional mammograms, tests, or exams before the doctor can tell for sure. You may also be referred to a breast specialist or a surgeon. It does not necessarily mean you have cancer or need surgery. These doctors are experts in diagnosing breast problems. Doctors may order some of these tests:
Diagnostic mammogram, to focus on a specific area of the breast
Ultrasound, an imaging test that uses sound waves to create a picture of your breast. The pictures may show whether a lump is solid or filled with fluid. A cyst is a fluid-filled sac. Cysts are not cancer. But a solid mass may be cancer. After the test, your doctor can store the pictures on video or print them out. This exam may be used along with a mammogram.
Magnetic resonance imaging (MRI), which uses a powerful magnet linked to a computer. MRI makes detailed pictures of breast tissue. Your doctor can view these pictures on a monitor or print them on film. MRI may be used along with a mammogram.
Biopsy, a test in which fluid or tissue is removed from your breast to help find out if there is cancer. Your doctor may refer you to a surgeon or to a doctor who is an expert in breast disease for a biopsy.
What is the Breast Imaging Reporting and Database System (BI-RADS®)?
The American College of Radiology (ACR) has established a uniform way for radiologists to describe mammogram findings. The system, called BI-RADS, includes seven standardized categories, or levels. Each BI-RADS category has a follow-up plan associated with it to help radiologists and other physicians appropriately manage a patient’s care.
Breast Imaging Reporting and Database System (BI-RADS)
Category
Assessment
Follow-up
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Need additional imaging evaluation
Additional imaging needed before a category can be assigned
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Negative
Continue regular screening mammograms
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Benign (noncancerous) finding
Continue regular screening mammograms
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Probably benign
Receive a 6-month follow-up mammogram
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Suspicious abnormality
May require biopsy
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Highly suggestive of malignancy (cancer)
Requires biopsy
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Known biopsy-proven malignancy (cancer)
Biopsy confirms presence of cancer before treatment begins
BI-RADS also includes four categories of breast density that may be reported. The radiologist who reads the mammogram chooses the category that best describes the level of breast density seen on the mammogram film. The categories, from the least amount of breast density to the highest, are as follows:
The breasts are almost entirely fatty
There are scattered areas of dense glandular tissue and fibrous connective tissue (together known as fibroglandular density)
The breasts are heterogeneously dense, which means they have more of these areas of fibroglandular density. This may make it hard to see small masses in the breast tissue on a mammogram.
The breasts are extremely dense, which makes it hard to see tumors in the breast tissue on a mammogram.
Many states in the U.S. have enacted laws requiring mammography providers to tell women if they have dense breasts (i.e., breasts that are heterogeneously or extremely dense on a mammogram) and to inform them of risks associated with having dense breasts. In addition to making mammograms harder to read, dense breasts are a risk factor for breast cancer.
Although they are not perfect, mammograms are the best method to find breast changes that cannot be felt. If your mammogram shows a breast change, sometimes other tests are needed to better understand it. Even if the doctor sees something on the mammogram, it does not mean it is cancer.
As with any medical test, mammograms have limits. These limits include:
They are only part of a complete breast exam. Your doctor also should do a clinical breast exam. If your mammogram finds something abnormal, your doctor will order other tests.
Finding cancer does not always mean saving lives. Even though mammography can detect tumors that cannot be felt, finding a small tumor does not always mean that a woman's life will be saved. Mammography may not help a woman with a fast growing cancer that has already spread to other parts of her body before being found.
False negatives can happen. This means everything may look normal, but cancer is actually present. False negatives don't happen often. Younger women are more likely to have a false negative mammogram than are older women. The dense breasts of younger women make breast cancers harder to find in mammograms.
False positives can happen. This is when the mammogram results look like cancer is present, even though it is not. False positives are more common in younger women, women who have had breast biopsies, women with a family history of breast cancer, and women who are taking estrogen, such as menopausal hormone therapy.
Mammograms (as well as dental x-rays and other routine x-rays) use very small doses of radiation. The risk of any harm is very slight, but repeated x-rays could cause cancer. The benefits nearly always outweigh the risk. Talk to your doctor about the need for each x-ray. Ask about shielding to protect parts of the body that are not in the picture. You should always let your doctor and the technician know if there is any chance that you are pregnant.
https://www.womenshealth.gov/a-z-topics/mammograms [accessed on Feb 16, 2019]
https://www.nibib.nih.gov/science-education/science-topics/mammography [accessed on Feb 16, 2019]
https://www.cdc.gov/cancer/breast/basic_info/mammograms.htm [accessed on Feb 16, 2019]
https://www.cancer.gov/types/breast/mammograms-fact-sheet [accessed on Feb 16, 2019]
https://www.cancer.gov/types/breast/breast-changes#ui-id-4 [accessed on Feb 16, 2019]
https://www.fda.gov/ForConsumers/ByAudience/ForWomen/WomensHealthTopics/ucm117967.htm [accessed on Feb 16, 2019]
https://medlineplus.gov/ency/article/003380.htm [accessed on Feb 16, 2019]
https://www.healthline.com/health/birads-score [accessed on Feb 16, 2019]
https://www.acr.org/-/media/ACR/Files/RADS/BI-RADS/Mammography-Reporting.pdf [accessed on Feb 16, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (48)
Mammography Fact Sheet
Mammography is an x-ray imaging method used to examine the breast for the early detection of cancer and other breast diseases. It is used as both a diagnostic and screening tool.
Document by www.nibib.nih.gov
Mammograms
Document by Office on Women's Health, U.S. Department of Health and Human Services
Top Four Mammogram Myths
Knowing the truth about mammograms could help save your life, or the life of someone you love. Over 60% of breast cancer cases are diagnosed before they spread. Nearly 90% of women who find and treat their breast cancer are cancer-free at five years. Mammograms can help reduce the number of deaths from breast cancer among women ages 40 to 70.
Image by The U.S. Food and Drug Administration
Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations
Image by TheVisualMD
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Mammography
A woman getting a mammogram, showing a cone in position on her right breast.
Image by National Cancer Institute / Unknown Illustrator
Mammography
Image by BruceBlaus
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Mammogram
An adult female is assisted in a mammogram machine by an African-American technician.
Image by National Cancer Institute / Alan Hoofring (Illustrator)
Woman Having Mammogram
Photograph of woman having mammogram. Mammograms are considered the gold standard for breast cancer screening. Mammography requires the breasts to be compressed between plates while the image is captured. Typically, two views are taken of the breast: cranial-caudal (top to bottom) and mediolateral oblique (angled side view).
Image by TheVisualMD
Mammography
Mammogram being conducted
Image by CDC
Woman Receives Mammogram
An African-American female technician positions a Caucasian woman at an imaging machine to receive a mammogram.
Image by National Cancer Institute / Rhoda Baer (Photographer)
Woman Receives Mammogram
A Caucasian female technician positions an Asian woman at an imaging machine to receive a mammogram.
Image by National Cancer Institute / Rhoda Baer (Photographer)
Woman Receives Mammogram
A Caucasian female technician positions a Hispanic woman at an imaging machine to receive a mammogram.
Image by National Cancer Institute / Rhoda Baer (Photographer)
Woman Receives Mammogram
An Asian female technician positions an African-American woman at an imaging machine to receive a mammogram.
Image by National Cancer Institute / Rhoda Baer (Photographer)
Mammography Patient
A female technician prepares to give an older Caucasian female patient a mammogram. the patient is preparing for the exam next to machine with technician in background adjusting controls.
Image by National Cancer Institute / Bill Branson (Photographer)
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Mammography
A woman's breast being compressed to get the optimum mammographic image.
Image by National Cancer Institute / Bill Branson (Photographer)
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Mammography
A Caucasian female patient, while sitting, is receiving a mammogram with a technician is standing in the background. The conical tip is compressing the right breast and the left breast is visible. Note the older machine.
Image by National Cancer Institute / Unknown Photographer
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Mammography
A Caucasian female patient receives a lateral mammogram treatment. She is lying on her left side with the left breast compressed and she is holding her right breast out of the way so as to not block the x-ray. Note the older methods of the diagnostic procedure.
Image by National Cancer Institute / Unknown Photographer
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Mammography
A female Caucasian radiology technician preparing a 42 year old Caucasian woman for a mammogram. The technician is positioning the paddle that compresses the breast. The patient's face is turned towards the technician, away from the camera, and her right shoulder and breast are exposed.
Image by National Cancer Institute / Bill Branson (Photographer)
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Mammography
A female Caucasian radiology technician preparing a 42 year old Caucasian woman for a mammogram. The technician is positioning the paddle used to compress the breast. The patient's face is turned towards the technician, away from the camera, with her right shoulder and breast are exposed.
Image by National Cancer Institute / Bill Branson (Photographer)
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Mammography Patient
A female Caucasian radiology technician preparing a 42 year old Caucasian woman for a mammogram. The technician is positioning the paddle used to compress the breast. The patient's face is turned towards the technician, away from the camera. Her right shoulder is raised obscuring the breast.
Image by National Cancer Institute / Bill Branson (Photographer)
Male Breast Cancer
Senior Airman Elisabeth Stone compresses a male patient's breast tissue during a baseline screening of mammogram at Joint Base Elmendorf-Richardson, Alaska
Image by Staff Sgt. Sheila deVera
Doctor Viewing Mammogram
A doctor examines mammograms on a view box.
Image by National Cancer Institute / Bill Branson (photographer)
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Mammogram Showing Dense And Fatty Breasts
Title Mammogram Showing Dense And Fatty Breasts Description A side-by-side of two normal mammograms showing the difference between a dense breast (left) and a fatty breast (right). The dense breast is that of a woman aged 39, the fatty breast is that of a 59-year old woman. Abnormal lesions are easier to detect and diagnose in a fatty breast making mammography more accurate.
Image by Dr. Kathy Cho. NIH Radiology / National Cancer Institute
Abnormal Mammogram
This abnormal mammogram is not necessarily cancerous. Also seen are calcifications through ductal patterns. Patient would be avised to have follow-up at 3-month intervals.
Image by National Cancer Institute / Unknown Photographer
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Mammogram vs. MRI
A mammography on left and a Magnetic resonance image (MRI) on right. Breast imaging technology has changed over the years. Note MRI's enhancement ability to confirm diagnosis.
Image by Mitchell D. Schnall, M.D., Ph.D. University Of Pennsylvania / Unknown Photographer
Bilateral digital mammography images of the breasts
Bilateral digital mammography images of the breasts; mediolateral oblique view.
Normal (left) versus cancerous (right) mammography image.
Normal (left) versus cancerous (right) mammography image.
Image by National Cancer Institute
Duct ectasia of breast
Detail of a mammography showing liponecrosis (round/oval calcifications) and plasma cell mastitis with typical rod-like calcifications
Image by Hellerhoff
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Mammogram - Normal
Breast tomosynthesis (3D Mammography) of the left craniocaudal.
Image by National Cancer Institute (NCI)
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Mammogram - Normal
Breast tomosynthesis (3D Mammography) of the left craniocaudal projection.
Image by National Cancer Institute (NCI)
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Mammogram - Normal
Breast tomosynthesis (3D Mammography) of the left craniocaudal reconstruction.
Image by National Cancer Institute (NCI)
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Mammogram - Normal
Breast tomosynthesis (3D Mammography) of the left mediolateral oblique projection.
Image by National Cancer Institute (NCI)
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Mammogram Showing Dense And Fatty Breasts
A side-by-side of two normal mammograms showing the difference between a dense breast (left) and a fatty breast (right). The dense breast is that of a woman aged 39, the fatty breast is that of a 59-year old woman. Abnormal lesions are easier to detect and diagnose in a fatty breast making mammography more accurate.
Image by Dr. Kathy Cho. NIH Radiology / Unknown Photographer
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Thermography of breast
Image by FDA
Mammograms vs Breast Ultrasounds
Video by Lee Health/Vimeo
Breast Density: Higher Risk & New Screening Options
Video by Breast Cancer School for Patients/YouTube
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Mammography: NCI B-roll [video]
NCI B-roll of female patient (simulated) receiving a digital mammogram. This video is intentionally silent. This footage, which was filmed at Sibley Memorial Hospital (a Johns Hopkins affiliate institution), includes images of a technician setting up the equipment, a Caucasian female being positioned to receive a mammogram, and mammography images of of dense breasts and fatty breasts. Downloadable video files are 960x540 at 30 fps. This image is part of the NCI B-Roll Videos collection.
View video using embedded player on this page or at youtube.com.
Video by National Cancer Institute (NCI)
What to Expect -- Digital Mammography
Video by Hologic, Inc./YouTube
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Mammography
Breast radiologist Dr.Gillian Newstead of the University of Chicago Medical Center explains the process of a typical mammogram screening.
Video by TheVisualMD
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Breast Density
Women with dense breast tissue often require a further look with ultrasound for screening. University of Chicago Medical Center breast radiologist Dr. Gillian Newstead and a breast cancer survivor with dense breast tissue explain.
Video by TheVisualMD
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Breast Cancer Screening & Diagnosis
Breast cancer is one of the most common cancers among women in the U.S., with about 1 in 8 women developing the disease within her lifetime. Breast cancer is an uncontrolled growth of breast cells that has the potential to spread into the breast and possibly to other parts of the body. Early detection through screening saves the lives of thousands of women every year. If there is a history of breast cancer in the family, women should consider the BReast CAncer susceptibility test (or BRCA) to identify a gene that may indicate an increased risk of developing the disease. Women forty and over should be screened for abnormalities yearly to detect and evaluate changes in breast tissue. If an abnormality is found, a biopsy and pathological exam are necessary for a definitive diagnosis and prognosis. After diagnosis, your doctor may want to learn more about your specific cancer through immunohistochemistry (IHC) and HER2 protein tests. IHC testing can help determine if a specific abnormality is present in the cancer cells. HER2 tests can tell your physician if the breast cancer is turned on by the HER2 gene, and can help determine the best course of treatment. Knowing what type of breast cancer is involved, what stage the cancer is, and the characteristics of that specific cancer, allows a woman's physician to determine best possible therapy for her individual case.
Video by TheVisualMD
A closer look at modern mammography
Video by Siemens Healthineers/YouTube
Mammogram
A mammographic image is displayed on state of the art mammography monitors at the David Grant USAF Medical Center. (U.S. Air Force photo/Staff Sgt. Liliana Moreno)
Image by U.S. Air Force photo/Staff Sgt. Liliana Moreno
Nipple Aspirate Test No Substitute for Mammogram
Some companies are marketing a new test—the nipple aspirate test—as the latest and greatest tool in early breast cancer screening. But FDA warns that the nipple aspirate test is no substitute for a mammogram.
Image by The U.S. Food and Drug Administration
Do More Screening Tests Lead to Better Health? Choosing Wisely
Video by DocMikeEvans/YouTube
New Guidelines for Mammograms
Video by Lee Health/Vimeo
Mammogram questions | Mercy Health
Video by Bon Secours Mercy Health/Vimeo
Getting Screened for Breast Cancer
Video by Lee Health/Vimeo
Mammography Fact Sheet
www.nibib.nih.gov
Mammograms
Office on Women's Health, U.S. Department of Health and Human Services
Top Four Mammogram Myths
The U.S. Food and Drug Administration
Screening for Cancer
TheVisualMD
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Mammography
National Cancer Institute / Unknown Illustrator
Mammography
BruceBlaus
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Mammogram
National Cancer Institute / Alan Hoofring (Illustrator)
Woman Having Mammogram
TheVisualMD
Mammography
CDC
Woman Receives Mammogram
National Cancer Institute / Rhoda Baer (Photographer)
Woman Receives Mammogram
National Cancer Institute / Rhoda Baer (Photographer)
Woman Receives Mammogram
National Cancer Institute / Rhoda Baer (Photographer)
Woman Receives Mammogram
National Cancer Institute / Rhoda Baer (Photographer)
Mammography Patient
National Cancer Institute / Bill Branson (Photographer)
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Mammography
National Cancer Institute / Bill Branson (Photographer)
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Mammography
National Cancer Institute / Unknown Photographer
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Mammography
National Cancer Institute / Unknown Photographer
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Mammography
National Cancer Institute / Bill Branson (Photographer)
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Mammography
National Cancer Institute / Bill Branson (Photographer)
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Mammography Patient
National Cancer Institute / Bill Branson (Photographer)
Male Breast Cancer
Staff Sgt. Sheila deVera
Doctor Viewing Mammogram
National Cancer Institute / Bill Branson (photographer)
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Mammogram Showing Dense And Fatty Breasts
Dr. Kathy Cho. NIH Radiology / National Cancer Institute
Abnormal Mammogram
National Cancer Institute / Unknown Photographer
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Mammogram vs. MRI
Mitchell D. Schnall, M.D., Ph.D. University Of Pennsylvania / Unknown Photographer
Bilateral digital mammography images of the breasts
Normal (left) versus cancerous (right) mammography image.
National Cancer Institute
Duct ectasia of breast
Hellerhoff
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Mammogram - Normal
National Cancer Institute (NCI)
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Mammogram - Normal
National Cancer Institute (NCI)
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Mammogram - Normal
National Cancer Institute (NCI)
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Mammogram - Normal
National Cancer Institute (NCI)
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Mammogram Showing Dense And Fatty Breasts
Dr. Kathy Cho. NIH Radiology / Unknown Photographer
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Thermography of breast
FDA
1:51
Mammograms vs Breast Ultrasounds
Lee Health/Vimeo
8:30
Breast Density: Higher Risk & New Screening Options
Breast Cancer School for Patients/YouTube
2:39
Mammography: NCI B-roll [video]
National Cancer Institute (NCI)
4:07
What to Expect -- Digital Mammography
Hologic, Inc./YouTube
0:37
Mammography
TheVisualMD
0:43
Breast Density
TheVisualMD
4:57
Breast Cancer Screening & Diagnosis
TheVisualMD
3:37
A closer look at modern mammography
Siemens Healthineers/YouTube
Mammogram
U.S. Air Force photo/Staff Sgt. Liliana Moreno
Nipple Aspirate Test No Substitute for Mammogram
The U.S. Food and Drug Administration
10:18
Do More Screening Tests Lead to Better Health? Choosing Wisely
DocMikeEvans/YouTube
1:41
New Guidelines for Mammograms
Lee Health/Vimeo
1:08
Mammogram questions | Mercy Health
Bon Secours Mercy Health/Vimeo
1:45
Getting Screened for Breast Cancer
Lee Health/Vimeo
Pap Smear
Pap Smear
Also called: Papanicolaou Smear, Cervical Smear, Cervical Cytology, Vaginal Cytology, Cervical Screening, Gynecologic Pap Test
A Pap smear is a routine test that looks for abnormal cells in the cervix (the uppermost portion of the vagina). Finding and treating these cells early can help prevent cervical cancer.
Pap Smear
Also called: Papanicolaou Smear, Cervical Smear, Cervical Cytology, Vaginal Cytology, Cervical Screening, Gynecologic Pap Test
A Pap smear is a routine test that looks for abnormal cells in the cervix (the uppermost portion of the vagina). Finding and treating these cells early can help prevent cervical cancer.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A negative or normal test result is reported as "Negative for intraepithelial lesion or malignancy". However, a negative report may also note benign findings such as infections or inflammation.
Related conditions
A Pap smear is a test to help prevent cervical cancer or find it early. The cervix is the lower, narrow end of the uterus that opens into the vagina. During a Pap smear, a health care provider collects cells from the cervix and sends them to a lab.
At the lab, the cells are checked under a microscope for cancer or for signs that they may become cancer. Cells that may become cancer are called precancers. Finding and treating precancers can help prevent cervical cancer. The Pap smear is also a reliable way to find cancer early when it's easier to treat.
Other names for a Pap smear: Pap test, cervical cytology, Papanicolaou test, Pap smear test, vaginal smear technique
A Pap smear looks for abnormal changes in cervical cells before they become cancer. Sometimes the cells collected during a Pap smear are also checked for HPV, a virus that can cause cell changes that may lead to cancer.
Pap smears and HPV tests are cervical cancer screening tests that look for cancer before you have any symptoms. Research shows that cervical cancer screening can greatly reduce the number of new cervical cancer cases and deaths from the disease. Ask your provider which test is right for you or if you should have both a Pap smear and an HPV test.
In general, if you're between age 21 and 65, you should have regular Pap smears:
If you're between ages 21 and 29 and your last Pap test result was normal, your provider may say you can wait three years until your next test.
If you're between ages 30 and 65 and your last Pap smear result was normal:
Your provider may say you can wait three years until your next test.
If you also had a normal HPV test result, your provider may say that you can wait five years until your next test.
If you're over age 65, your provider may tell you that you don't need Pap smears anymore if you:
Have had normal Pap smears for several years.
Have had surgery to remove your uterus and cervix because you had a condition that was not cancer, such as fibroids.
If you have a higher risk for developing cervical cancer, your provider may recommend screening more often or after age 65. You may have a higher risk if you:
Had an abnormal Pap smear in the past
Have HIV
Have a weakened immune system
Were exposed to a drug called DES (Diethylstilbestrol) before you were born. Between the years 1940–1971, DES was prescribed during pregnancy to prevent miscarriages. It was later linked to an increased risk of certain cancers in the female children exposed to it during the pregnancy.
If you're under age 21, cervical cancer screening is not recommended. Your risk of cervical cancer is very low. Also, any changes in cervical cells are likely to go away on their own.
If you are unsure whether you need a Pap smear, talk with your provider.
During a Pap smear you will lie on an exam table. Your provider will use a plastic or metal instrument called a speculum to widen the vagina, so the cervix can be seen. Your provider will then use a small, soft brush or swab to collect cells from the cervix. The cell sample is sent to a lab for testing.
A Pap smear is often done as part of a pelvic exam. During a pelvic exam, your provider examines your uterus, ovaries, and genital area. But a pelvic exam doesn't always include a Pap smear. So, when you have a pelvic exam, ask your provider whether you'll have a Pap smear, too.
You should not have a Pap smear while you are having your period. A good time to have the test is about five days after the last day of your period. For two to three days before your test, you should not:
Use tampons
Use birth control foam, jelly, or cream
Use other creams or medicines in the vagina
Douche (rinse the vagina with water or other fluid)
Have vaginal sex
You may feel some mild discomfort during a Pap smear. Afterwards, you may have some very light bleeding. But there are no known risks to having a Pap smear.
A Pap smear test has three possible results:
Normal Pap smear or "negative" result. No abnormal changes were found in the cells of your cervix. Your provider may tell you that you can wait three years for your next test. If you also had a normal HPV test result, you may be able to wait five years for your next test, depending on your age and medical history.
Unclear or unsatisfactory results. The lab sample may not have had enough cells, or the cells may have been clumped together or hidden by mucus. Your provider will usually ask you to come in for another test in 2 to 4 months.
Abnormal Pap smear or "positive" result. Abnormal changes were found in your cervical cells. Most of the time, abnormal results do not mean you have cervical cancer. Minor changes in the cells usually go back to normal on their own. But your provider may recommend a follow-up test to check. More serious cell changes may turn into cancer if they are not removed. Finding and treating these cells early can help prevent cancer from developing.
Talk with your health care provider to learn what your Pap smear results mean.
Thousands of women in the U.S. die from cervical cancer every year. A Pap smear, along with an HPV test, is one of the most effective ways to prevent cervical cancer.
Pap Smear: MedlinePlus Lab Test Information [accessed on Dec 20, 2018]
Definition of atypical squamous cells of undetermined significance - NCI Dictionary of Cancer Terms - National Cancer Institute [accessed on Dec 20, 2018]
192005: Gynecologic Pap Test, Liquid-based Preparation | LabCorp [accessed on Dec 28, 2018]
https://www.acog.org/Patients/FAQs/Abnormal-Cervical-Cancer-Screening-Test-Results [accessed on Dec 28, 2018]
Understanding Abnormal Cervical Cancer Screening Results [accessed on Dec 28, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (19)
A cervical screening test - What can you expect?
Video by Healthchanneltv / cherishyourhealthtv/YouTube
Cervical Dysplasia (Gynecology - Pap Smear)
Video by Med Twice/YouTube
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Pap Smear showing Chlamydia
Human pap smear showing Chlamydia in the vacuoles at 500x and stained with H&E.
Image by Dr. Lance Liotta Laboratory / Unknown Photographer
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Pap Test: Pap Smear (Pap Test)
A Pap smear, also called a Pap test, is a procedure to test for cervical cancer as well as a number of different types of infections. The test involves collecting cells from the cervix. A speculum is inserted into the vagina, and samples of cervical cells are collected and examined under a microscope for abnormalities. Detecting cervical cancer early with a Pap smear gives women a greater chance of being cured. A Pap smear can also detect changes in cervical cells that suggest cancer may develop in the future. The Pap smear is usually done in conjunction with a pelvic exam. In women over 30, the Pap smear may be combined with a test for human papillomavirus (HPV), a common sexually transmitted infection that may cause cervical cancer in some women.
Image by TheVisualMD
Pap Test: Human Papillomavirus (HPV)
The human papillomavirus (HPV) is responsible for genital HPV infection, one of the most common sexually transmitted diseases. Incurable and often asymptomatic, genital HPV infection is spread through genital, skin-to-skin contact. It may cause genital warts and can lead to cervical cancer as well as some cases of anal, rectal, and penile cancer. There are more than 100 strains of HPV, and more than 30 of these are transmitted sexually. However, only a small subset of these strains are cancer-causing. Pap smear testing is used to detect abnormal cells caused by genital HPV infection that could lead to cervical cancer if left untreated. HPV vaccines are available for both men and women to prevent infection by some of the more dangerous virus strains associated with the development of cervical cancer.
Image by TheVisualMD
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HPV E6 E7 mRNA and Pap Tests
HPV E6 E7 mRNA and Pap Tests: Pap tests (ie, cervical cytology) are the most common way to screen for cervical cancer and routine Pap testing is credited with widely reducing the incidence of cervical cancer since the tests implementation. Pap tests are, however, limited by their relatively low sensitivity and specificity.Studies suggest that testing for high-risk HPV DNA is a more sensitive method of determining a woman`s risk of developing cervical cancer. Though current high-risk HPV DNA testing methods provide adequate sensitivity, specificity is lacking, which can lead to false-positive results and unnecessary invasive procedures such as colposcopy and biopsy. Its important for every woman to talk to her doctor about what tests are right for her.
Image by TheVisualMD
Pap smears vs HPV testing and cervical cancer detection
Video by Pathology Tests Explained/YouTube
Human Papillomavirus (HPV)
Risk Factors for Cancer: Virus : Medical visualization of an anterior close-up view of a human papillomavirus (HPV) capsid the virus responsible for genital HPV infection one of the most common sexually transmitted infections. Often asymptomatic genital HPV infection is spread through genital skin-to-skin contact causes genital warts and can lead to cervical cancer as well as some cases of anal rectal and penile cancer. There are more than 100 strains of HPV and more than 40 of these are transmitted sexually; however only a small subset of those are cancer-causing. Pap smear testing is used to detect abnormal cells caused by genital HPV infection that could lead to cervical cancer if left untreated. Consistent condom use has been shown to reduce the risk of HPV infection by as much as 70% but condoms do not protect all anatomy vulnerable to the virus. Vaccines that can prevent initial infection of some of the more dangerous strains are widely available.
Image by TheVisualMD
Pap Smear
A female Caucasian scientist examining pap smears under the microscope.
Image by National Cancer Institute / Bill Branson (Photographer)
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Pap Smear Laser
One of the many uses for the laser in medical research is as a light source to detect premalignant and malignant cells in a Pap smear. Gynecologic cells passing in a stream through the laser beam where each cell is analyzed. Abnormal-appearing cells can be sorted from the rest of the cells and later examined by a pathologist for evidence of cancer.
Image by National Cancer Institute / Unknown Photographer
Endometrial Cancer
Endometrial cancer is the most commonly diagnosed gynecological cancer. Women with clear cell endometrial cancer, a rare type of endometrial cancer, generally have poorer clinical outcomes
Image by Darryl Leja, NHGRI
Advanced Cancer Cell Growth in Cervix
Three-dimensional visualization reconstructed from scanned human data. Superiolateral view of cross-section of advanced cancerous cell growth of cervix. Cervical cancer begins with precancerous cellular changes, often caused by human papillomavirus (HPV.) There are two main types of cervical cancer: squamous cell carcinoma (the most common type at 80%+) and adenocarcinoma. Squamous cell carcinoma develops from the cells that cover the surface of the cervix, while adenocarcinoma develops from mucous-producing glandular tissue. Cervical cancer is highly preventable, with precancerous cells visible on a regular Pap smear. Also, a vaccine is being developed that could prevent initial infection of some of the more dangerous strains of HPV that lead to precancerous cellular changes. 3 of 3.
Image by TheVisualMD
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Healthy Cervix
The cervix is the lower portion of the uterus where it joins with the top of the vagina. The opening of the the cervix into the vagina is called the external os, and can vary in appearance from a small, circular opening in women who have not given birth, to a wider, more slit-like opening in women who have had children. Human papillomavirus (HPV) is associated with an increased risk of cervical cancer. Women should be screened for cellular changes of the cervix with a pap smear as part of a regular pelvic exam. Human papillomavirus (HPV) is a large group of related viruses that are often sexually transmitted. Most infections clear up quickly and cause few problems, though HPV can cause genital warts. Infection by certain types of HPV, however, can lead to cervical cancer. In 2006, the FDA approved an HPV vaccine (Gardisil) that protects against viral types that cause most cases of cervical cancer as well as genital warts. Public health experts recommend routine vaccination for girls ages 11-12 to ensure vaccine effectiveness.
Image by TheVisualMD
Studying Cells
These uterine cervix cells, viewed through a light microscope, were obtained from a Pap smear. Normal cells are on the left. The cells on the right are infected with human papillomavirus (HPV). Notice that the infected cells are larger; also, two of these cells each have two nuclei instead of one, the normal number. (credit: modification of work by Ed Uthman, MD; scale-bar data from Matt Russell)
Image by CNX Openstax
Human Papillomavirus (HPV)
Medical visualization of an anterior close-up view of a human papillomavirus (HPV) capsid, the virus responsible for genital HPV infection, one of the most common sexually transmitted diseases. Incurable and often asymptomatic, genital HPV infection is spread through genital, skin-to-skin contact, causes genital warts, and can lead to cervical cancer, as well as some cases of anal, rectal, and penile cancer. There are more than 100 strains of HPV, and more than 30 of these are transmitted sexually; however, only a small subset of those are cancer-causing. Pap smear testing is used to detect abnormal cells caused by genital HPV infection that could lead to cervical cancer if left untreated. A vaccine is being developed that could prevent initial infection of some of the more dangerous strains.
Image by TheVisualMD
Human Papillomavirus (HPV)
Anterior view of a human papillomavirus (HPV) capsid, the virus responsible for genital HPV infection, one of the most common sexually transmitted diseases. Incurable and often asymptomatic, genital HPV infection is spread through genital, skin-to-skin contact, causes genital warts, and can lead to cervical cancer, as well as some cases of anal, rectal, and penile cancer. There are more than 100 strains of HPV, and more than 30 of these are transmitted sexually; however, only a small subset of those are cancer-causing. Pap smear testing is used to detect abnormal cells caused by genital HPV infection that could lead to cervical cancer if left untreated. A vaccine is being developed that could prevent initial infection of some of the more dangerous strains.
Image by TheVisualMD
Normal Cell Growth in Cervix
Three-dimensional visualization reconstructed from scanned human data. Superiolateral view of cross-section of healthy cervical cells. Cervical cancer begins with precancerous cellular changes, often caused by human papillomavirus (HPV.) There are two main types of cervical cancer: squamous cell carcinoma (the most common type at 80%+) and adenocarcinoma. Squamous cell carcinoma develops from the cells that cover the surface of the cervix, while adenocarcinoma develops from mucous-producing glandular tissue. Cervical cancer is highly preventable, with precancerous cells visible on a regular Pap smear. Also, a vaccine is being developed that could prevent initial infection of some of the more dangerous strains of HPV that lead to precancerous cellular changes. 1 of 3.
Image by TheVisualMD
Uterus and Cervix Sagittal Section
Medical visualization of a lateral cross-section of a healthy cervix, as well as the uterus and vagina. Cervical cancer begins with precancerous cellular changes, often caused by human papillomavirus (HPV.) There are two main types of cervical cancer: squamous cell carcinoma (the most common type at 80%+) and adenocarcinoma. Squamous cell carcinoma develops from the cells that cover the surface of the cervix, while adenocarcinoma develops from mucous-producing glandular tissue. Cervical cancer is highly preventable, with precancerous cells visible on a regular Pap smear. Also, a vaccine is being developed that could prevent initial infection of some of the more dangerous strains of HPV that lead to precancerous cellular changes. 1 of 2.
Image by TheVisualMD
Human Papillomavirus (HPV)
Medical visualization of an anterior close-up view of a human papillomavirus (HPV) capsid, the virus responsible for genital HPV infection, one of the most common sexually transmitted infections.
Image by TheVisualMD
2:13
A cervical screening test - What can you expect?
Healthchanneltv / cherishyourhealthtv/YouTube
6:01
Cervical Dysplasia (Gynecology - Pap Smear)
Med Twice/YouTube
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Pap Smear showing Chlamydia
Dr. Lance Liotta Laboratory / Unknown Photographer
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Pap Test: Pap Smear (Pap Test)
TheVisualMD
Pap Test: Human Papillomavirus (HPV)
TheVisualMD
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HPV E6 E7 mRNA and Pap Tests
TheVisualMD
3:40
Pap smears vs HPV testing and cervical cancer detection
Pathology Tests Explained/YouTube
Human Papillomavirus (HPV)
TheVisualMD
Pap Smear
National Cancer Institute / Bill Branson (Photographer)
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Pap Smear Laser
National Cancer Institute / Unknown Photographer
Endometrial Cancer
Darryl Leja, NHGRI
Advanced Cancer Cell Growth in Cervix
TheVisualMD
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Healthy Cervix
TheVisualMD
Studying Cells
CNX Openstax
Human Papillomavirus (HPV)
TheVisualMD
Human Papillomavirus (HPV)
TheVisualMD
Normal Cell Growth in Cervix
TheVisualMD
Uterus and Cervix Sagittal Section
TheVisualMD
Human Papillomavirus (HPV)
TheVisualMD
Colonoscopy
Colonoscopy
Also called: Coloscopy
Colonoscopy is an exam in which a doctor uses a colonoscope, to look inside your rectum and colon. Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.
Colonoscopy
Also called: Coloscopy
Colonoscopy is an exam in which a doctor uses a colonoscope, to look inside your rectum and colon. Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Normal findings are healthy intestinal tissues. If no abnormalities are discovered, an adult at average risk of colon cancer is generally advised to have a repeat colonoscopy 10 years until age 75.
Related conditions
Colonoscopy is a exam in which a doctor uses a flexible tube with a camera on one end, called a colonoscope or scope, to look inside your rectum and colon. The rectum and colon make up most of your large intestine.
Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.
A colonoscopy is used:
to look for early signs of cancer in the colon and rectum. It may be part of a routine screening, which usually starts at age 45.
to look for causes of unexplained changes in bowel habits
to evaluate symptoms like abdominal pain, rectal bleeding, and weight loss
Your doctor can also remove polyps from your colon during the procedure.
You may need a colonoscopy to find the cause of unexplained symptoms such as:
Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
Changes in your bowel activity, such as diarrhea
Pain in your abdomen (belly)
Unexplained weight loss
Doctors also use the procedure to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you at higher risk, you may need to start getting screened for colorectal cancer earlier.
There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.
This test allows a provider to view your entire colon and rectum. It is often done in an outpatient department of a hospital or medical center. Before the test, you will need to empty out your colon (large bowel) in a procedure called bowel prep. During the test:
You will lie on an exam table.
You will be given medicine called a sedative to help you relax. It also prevents you from feeling pain during the procedure. You may be awake for the test, but you probably won't remember anything.
A colonoscope, a thin, lighted tube with a camera attached, will be inserted into your rectum and up into your colon.
Your provider will look for colorectal polyps or other abnormal areas.
Your provider may remove polyps or tissue samples using special tools inserted through the scope.
Polyps or samples may be sent to a lab for testing.
The sedative you are given may make you drowsy for several hours. You should arrange for someone to drive you home.
For a colonoscopy, you will need to do a bowel prep. Your provider will give you specific instructions on how to do your bowel prep, but steps for bowel prep may include:
Following a liquid diet for one to three days before the test.
Drinking plenty of clear liquids one to three days before the test. Clear liquids include water, black coffee or tea, fat-free broth, and sports drinks without added color.
Drinking a strong liquid laxative and/or using an enema on the evening before your test.
The laxative or enema will help you empty your bowels. You should prepare to spend a lot of time in the bathroom. Bowel prep can be inconvenient and uncomfortable, but if the colon is not thoroughly cleaned out, your provider may not be able to get a full picture of your colon and rectum. Polyps and other abnormal areas may not be seen.
Serious risks of colonoscopy are rare but can include:
Tears in the colon or rectum wall
Bleeding
Reaction to the sedative
Normal findings are healthy intestinal tissues. Abnormal results may include the following:
Colorectal polyps or abnormal tissue were found and removed.
Samples were sent to a lab for testing.
Most polyps aren't cancerous but can turn into cancer if not removed. Depending on the size and number of polyps, your provider may recommend more frequent colonoscopies.
If you have questions about your results, talk to your health care provider.
You may feel cramping in your abdomen or bloating during the first hour after the colonoscopy. If the doctor removed polyps or performed a biopsy, you may have light bleeding from your anus. This bleeding is normal.
Colorectal Cancer Screening Tests: MedlinePlus Medical Test [accessed on Feb 10, 2024]
Colonoscopy - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. Feb 10, 2024 [accessed on Feb 10, 2024]
Colonoscopy | MedlinePlus. National Library of Medicine. Dec 5, 2022 [accessed on Feb 10, 2024]
Colonoscopy: MedlinePlus Medical Encyclopedia [accessed on Feb 10, 2024]
Robert H. Shmerling, MD. Understanding the results of your colonoscopy - Harvard Health. Oct 14, 2020 [accessed on Feb 10, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (40)
This browser does not support the video element.
Colorectal Cancer Clip 6
Colorectal Cancer Clip 6
Video by TheVisualMD
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Colorectal Cancer Clip 4
Colorectal Cancer Clip 4
Video by TheVisualMD
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Colorectal Cancer Clip 3
Colorectal Cancer Clip 3
Video by TheVisualMD
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Colorectal Cancer Screening
Colorectal cancer is one of the few preventable forms of cancer thanks to effective screening. For many people, screening for colorectal cancer is an unpleasant thought, but knowing your options and taking a pro-active approach especially if you're over 50 can save your life. In this video, you can learn the "ins and outs" of colonoscopy, as well as learn about a new technique called virtual colonoscopy, which uses high-tech CT scans to screen the colon.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Screening & Diagnosis
Colorectal cancer includes cancer of both the colon and rectum. It is the fourth most common cancer in the United States and the second leading cause of cancer-related deaths affecting both men and women equally. The CDC recommends that everyone age 50 or over be screened. When diagnosed early, patients have a 90% 5-year survival rate.
Video by TheVisualMD
Preparing for a Colonoscopy
Video by Dartmouth-Hitchcock/YouTube
Why No One Should Be Afraid of a Colonoscopy
Video by Stanford Health Care/YouTube
What are Colonoscopy Risks? • Risks of Colonoscopy | Colonoscopy Center of Excellence
Video by La Peer/YouTube
Having a colonoscopy
Video by Cancer Research UK/YouTube
The Importance of Good Bowel Preparation During Colonoscopy
Video by Johns Hopkins Medicine/YouTube
What is a colonoscopy and how do I prepare for it?
Video by You and Colonoscopy/YouTube
Virtual Colonoscopy Q&A | Dr. Karen Horton
Video by Johns Hopkins Medicine/YouTube
What to expect during a colonoscopy
Video by MD Anderson Cancer Center/YouTube
6 Reasons to Get a Colonoscopy
Video by Cleveland Clinic/YouTube
Colonoscopy Video Tour: Removal of a Colon Polyp (Polypectomy)
Video by AmCollege Gastro/YouTube
What happens during and after a colonoscopy?
Video by You and Colonoscopy/YouTube
How to prepare for a colonoscopy
Video by MD Anderson Cancer Center/YouTube
Colonoscopy and Flexible Sigmoidoscopy
Video by Gastro Pros/YouTube
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
Video by University of California Television (UCTV)/YouTube
Screening for Colorectal Cancer
Video by Dartmouth-Hitchcock/YouTube
What is Colorectal Cancer?
Video by Stanford Health Care/YouTube
Rectal Cancer | Q&A
Video by Johns Hopkins Medicine/YouTube
5 Things to Know About Colonoscopy - The Nebraska Medical Center
Video by Nebraska Medicine Nebraska Medical Center/YouTube
Video by PreOp.com Patient Engagement - Patient Education/YouTube
UCSF Radiology: How is Virtual Colonoscopy Performed?
Video by UCSF Imaging/YouTube
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Diagram showing a colonoscopy
Diagram showing a colonoscopy.
Image by Cancer Research UK / Wikimedia Commons
Virtual Colonoscopy 3D Model
With virtual colonoscopy, a computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is then created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Virtual Colonoscopy Slice of CT Data
Virtual colonoscopy is a new imaging technology that uses computed tomography (CT) images to look for polyps and cancer in the colon. A computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Colonoscopy or sigmoidoscopy testing
Drawing of a woman being tested for colon polyps. The woman is lying on her left side with her head on a pillow. In the background is a TV screen showing images of the colon.
Image by NIDDK Image Library
Colorectal Cancer Types of Surgery
Surgery is the main treatment for colorectal cancer. Polyps and very early stage cancers (Stage 0 and some early Stage I tumors) can be removed during a colonoscopy, using a variety of techniques. In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied. If it isn't possible to perform a resection (for instance, if the cancer is at the outlet of the rectum), a colostomy may be performed. In a colostomy, a portion of the large intestine is brought through the abdominal wall to carry stool out of the body, where it empties into a special bag. The colostomy may be temporary in order to allow the colon or rectum time to heal after surgery, or it may be permanent.
Image by TheVisualMD
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Capsule endoscopy
Image of the colon acquired by capsule endoscopy
Image by Dr.HH.Krause
All Views
Inside
Outside
Unfurled
1
2
3
4
Virtual Colonoscopy
Virtual colonoscopy is a new technology that uses computerized tomography (CT) images to look for polyps and cancer in the colon. The result is a computer-generated, animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy is performed for removal or biopsy of the growth.
Interactive by TheVisualMD
Virtual Colonoscopy open colon section view
After the image-taking procedure is complete, the cross-sectional pictures are processed by the computer to create animated, three-dimensional images of the large intestine. They are examined by a radiologist to identify any abnormal growths. If abnormalities are found, a conventional colonoscopy will be performed so that the abnormal growths can be removed or biopsied.
Image by TheVisualMD
Screening and Diagnosis Colonoscopy
A colonoscopy is an examination of the interior of the colon. It is often used as a screening tool for early detection of colorectal cancer. During a colonoscopy, a long flexible tube with a video camera at one end, called a colonoscope, is inserted first into the anus and then into the colon. The doctor can view the inside of the colon along its entire length on a video monitor.
Image by TheVisualMD
A Less Invasive Look
Virtual colonoscopy is a new technology that uses computed tomography (CT), or, less often, magnetic resonance imaging (MRI) images to look for polyps, cancer, or other diseases of the colon when an abnormality is suspected. A computer program assembles the images to create an animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy will need to be performed for removal or biopsy of the growth.
Image by TheVisualMD
Screening and Diagnosis Colonoscope
A colonoscopy is an examination of the interior of the colon. It is often used as a screening tool for early detection of colorectal cancer. During a colonoscopy, a long flexible tube with a video camera at one end, called a colonoscope, is inserted first into the anus and then into the colon. The doctor can view the inside of the colon along its entire length on a video monitor.
Image by TheVisualMD
Capsule endoscopy
Picture of a capsule
Image by Euchiasmus
Preparing for a colonoscopy
Video by AmerGastroAssn/YouTube
0:05
Colorectal Cancer Clip 6
TheVisualMD
0:15
Colorectal Cancer Clip 4
TheVisualMD
0:49
Colorectal Cancer Clip 3
TheVisualMD
4:13
Colorectal Cancer Screening
TheVisualMD
4:12
Colorectal Cancer Screening & Diagnosis
TheVisualMD
14:55
Preparing for a Colonoscopy
Dartmouth-Hitchcock/YouTube
3:35
Why No One Should Be Afraid of a Colonoscopy
Stanford Health Care/YouTube
2:56
What are Colonoscopy Risks? • Risks of Colonoscopy | Colonoscopy Center of Excellence
La Peer/YouTube
1:37
Having a colonoscopy
Cancer Research UK/YouTube
1:23
The Importance of Good Bowel Preparation During Colonoscopy
Johns Hopkins Medicine/YouTube
6:30
What is a colonoscopy and how do I prepare for it?
You and Colonoscopy/YouTube
8:26
Virtual Colonoscopy Q&A | Dr. Karen Horton
Johns Hopkins Medicine/YouTube
1:16
What to expect during a colonoscopy
MD Anderson Cancer Center/YouTube
3:17
6 Reasons to Get a Colonoscopy
Cleveland Clinic/YouTube
2:45
Colonoscopy Video Tour: Removal of a Colon Polyp (Polypectomy)
AmCollege Gastro/YouTube
5:15
What happens during and after a colonoscopy?
You and Colonoscopy/YouTube
8:08
How to prepare for a colonoscopy
MD Anderson Cancer Center/YouTube
2:49
Colonoscopy and Flexible Sigmoidoscopy
Gastro Pros/YouTube
1:26:06
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
University of California Television (UCTV)/YouTube
4:06
Screening for Colorectal Cancer
Dartmouth-Hitchcock/YouTube
3:47
What is Colorectal Cancer?
Stanford Health Care/YouTube
8:46
Rectal Cancer | Q&A
Johns Hopkins Medicine/YouTube
4:18
5 Things to Know About Colonoscopy - The Nebraska Medical Center
UCSF Radiology: How is Virtual Colonoscopy Performed?
UCSF Imaging/YouTube
Sensitive content
This media may include sensitive content
Diagram showing a colonoscopy
Cancer Research UK / Wikimedia Commons
Virtual Colonoscopy 3D Model
TheVisualMD
Virtual Colonoscopy Slice of CT Data
TheVisualMD
Colonoscopy or sigmoidoscopy testing
NIDDK Image Library
Colorectal Cancer Types of Surgery
TheVisualMD
Sensitive content
This media may include sensitive content
Capsule endoscopy
Dr.HH.Krause
Virtual Colonoscopy
TheVisualMD
Virtual Colonoscopy open colon section view
TheVisualMD
Screening and Diagnosis Colonoscopy
TheVisualMD
A Less Invasive Look
TheVisualMD
Screening and Diagnosis Colonoscope
TheVisualMD
Capsule endoscopy
Euchiasmus
1:15
Preparing for a colonoscopy
AmerGastroAssn/YouTube
Virtual Colonoscopy
Virtual Colonoscopy
Also called: Computed Tomographic Colonography, CT Colonography
Virtual colonoscopy is a non-invasive imaging method that uses computed tomographic data combined with specialized imaging software to examine the colon. It produces three-dimensional images of the colon which are examined for colorectal cancer and precancerous polyps.
Virtual Colonoscopy
Also called: Computed Tomographic Colonography, CT Colonography
Virtual colonoscopy is a non-invasive imaging method that uses computed tomographic data combined with specialized imaging software to examine the colon. It produces three-dimensional images of the colon which are examined for colorectal cancer and precancerous polyps.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
No abnormalities were detected in the colon. If you're at average risk of colon cancer, meaning you have no colon cancer risk factors other than age, your doctor may recommend repeating the exam in five years.
Related conditions
A method to examine the inside of the colon by taking a series of x-rays. A computer is used to make 2-dimensional (2-D) and 3-D pictures of the colon from these x-rays. The pictures can be saved, changed to give better viewing angles, and reviewed after the procedure, even years later.
Also called computed tomographic colonography, computed tomography colonography, CT colonography, and CTC.
You may need a virtual colonoscopy to find the cause of unexplained symptoms such as:
Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
Changes in your bowel activity, such as diarrhea
Pain in your abdomen (belly)
Unexplained weight loss
Doctors also use the procedure to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you at higher risk, you may need to start getting screened for colorectal cancer earlier.
There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.
This is a type of x-ray that uses a CT scan (computed tomography) to take detailed, 3-dimensional pictures of the entire colon and rectum. It is usually done in a radiology department of a hospital or medical center. This procedure also requires bowel prep beforehand. During the test:
You will lie on a narrow table.
You may be asked to drink a liquid containing contrast dye. Contrast dye is a substance that makes parts of your body show up more clearly on an x-ray.
A provider will insert a small tube into the rectum.
Air will be pumped through the tube to make the colon bigger and easier to see.
The table will slide into the CT machine.
A series of images will be taken.
For a virtual colonoscopy, you will need to do a bowel prep. Your provider will give you specific instructions on how to do your bowel prep, but steps for bowel prep may include:
Following a liquid diet for one to three days before the test.
Drinking plenty of clear liquids one to three days before the test. Clear liquids include water, black coffee or tea, fat-free broth, and sports drinks without added color.
Drinking a strong liquid laxative and/or using an enema on the evening before your test.
The laxative or enema will help you empty your bowels. You should prepare to spend a lot of time in the bathroom. Bowel prep can be inconvenient and uncomfortable, but if the colon is not thoroughly cleaned out, your provider may not be able to get a full picture of your colon and rectum. Polyps and other abnormal areas may not be seen.
In a virtual colonoscopy, risks include:
Exposure to a small dose of radiation from the scan.
Rarely, a tear in the colon or rectum can happen when it is inflated with air.
Normal findings are healthy intestinal tissues. Abnormal results may include the following:
Colorectal polyps or abnormal tissue were seen on the CT scan.
You will probably need a traditional colonoscopy so your provider can get a tissue sample. Sometimes this procedure can be done on the same day as your virtual colonoscopy.
If you have questions about your results, talk to your health care provider.
Colorectal Cancer Screening Tests: MedlinePlus Medical Test [accessed on Feb 12, 2024]
Colonoscopy | MedlinePlus. National Library of Medicine. Dec 5, 2022 [accessed on Feb 12, 2024]
Virtual Colonoscopy | NIDDK [accessed on Dec 28, 2018]
Tests to Detect Colorectal Cancer and Polyps - National Cancer Institute [accessed on Dec 28, 2018]
Colorectal Cancer Screening | Cancer Trends Progress Report [accessed on Dec 28, 2018]
CT Colonography [accessed on Dec 28, 2018]
Virtual colonoscopy - Mayo Clinic [accessed on Dec 28, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (14)
Virtual Colonoscopy 3D Model
With virtual colonoscopy, a computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is then created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Virtual Colonoscopy open colon section view
After the image-taking procedure is complete, the cross-sectional pictures are processed by the computer to create animated, three-dimensional images of the large intestine. They are examined by a radiologist to identify any abnormal growths. If abnormalities are found, a conventional colonoscopy will be performed so that the abnormal growths can be removed or biopsied.
Image by TheVisualMD
A Less Invasive Look
Virtual colonoscopy is a new technology that uses computed tomography (CT), or, less often, magnetic resonance imaging (MRI) images to look for polyps, cancer, or other diseases of the colon when an abnormality is suspected. A computer program assembles the images to create an animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy will need to be performed for removal or biopsy of the growth.
Image by TheVisualMD
This browser does not support the video element.
Colon unfurling
Virtual colonoscopy is a new technology that uses computed tomography (CT), or, less often, magnetic resonance imaging (MRI) images to look for polyps, cancer, or other diseases of the colon when an abnormality is suspected. A computer program assembles the images to create an animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy will need to be performed for removal or biopsy of the growth.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 3
Colorectal Cancer Clip 3
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 4
Colorectal Cancer Clip 4
Video by TheVisualMD
Spectrum of Medical Imaging
This composite image was created in recognition of The Society of Photo-Optical Instrumentation Engineers (SPIE) designation of 2015 as the “International Year of Light.” Medical imaging scientists and engineers contribute to the quest for the improved human condition by providing imaging that spans the entire usable electro-magnetic spectrum (seen at bottom). From the humblest of beginnings with simple magnification of objects and focusing with lenses, to the biological observation of cells with rudimentary microscopes in the visible spectrum, medical imaging today has both extended away from the visible spectrum towards longer and shorter wavelengths (low and high energies) and exploited the hyperspectral nature of the visible which was once considered “commonplace” or rudimentary. Considering yet a different cross-section through the various imaging modalities across the spectrum, the medically useful information gained spans anatomic, physiologic, and molecular regimes. Systems and algorithms have been developed as single-modality acquisition systems, and also as multiple-modalities with conjoint reconstruction, each informing the other in the quest to optimize image quality and information content. In addition, the role of light-based technologies in enabling advanced computations in tomographic reconstructions, computer-aided diagnosis, machine learning (neural networks, deep learning, etc.) , and 3D visualizations as well as in data-enriched storage of medical images has further extended the potential knowledge “seen” through imaging. The breadth of the electromagnetic spectrum offers limitless opportunities for improvement and inquiry, in our quest to answer human life’s difficult questions. This montage was first published on the cover of the SPIE’s Journal of Medical Imaging (July-Sept. 2015, vol. 3, no. 3) and is but a small tribute to the multitude of medical imaging scientists who have contributed to the wealth of new knowledge as we interrogate the human condition. The gray-scale whole body images (from Left to Right) are acquired from longer wavelength modalities to shorter wavelength modalities spanning the (currently) usable electromagnetic spectrum. The background images include: a coronal Magnetic Resonance Image (MRI) T2 weighted image slice, a posterior surface Infra Red (IR) heat map, a coronal non-contrast Computed Tomography (CT) slice, and a coronal 18F-fluoro-deoxyglucose Positron Emission Tomography (FDG-PET) slice. The selection of color inset images includes (from Top-to-Bottom, then Left to Right): [1] diffusion tensor magnetic resonance imaging (MRI) used to image long white matter tracts within and around the human brain illustrating neuronal connectivity (coloring refers to bluish=vertical direction; green=horizontal A-P direction; red=horizontal lateral direction) (courtesy of Arthur Toga, PhD); [2] registered and superimposed coronal proton-MRI (gray-scale) and a hyper polarized 129Xe ventilation MRI scan (color scale) within the same patient’s lungs, prior to their receiving a bronchial stent (courtesy of Bastiaan Driehuys, PhD); [3] coronal slice through a microwave-based image reconstruction of the Debye parameter ε (epsilon) in a heterogeneously dense human breast phantom (courtesy of Susan Hagness, PhD); [4] juxtaposed optical image of the retina and vertical and horizontal Optical Coherence Tomograph (OCT) slices showing pigmentosa retinopathy (courtesy of Jean-Michel Muratet, MD); [5] functional 3-D photoacoustic imaging of melanoma (gray scale) in vivo, surrounded by highly optically absorptive blood vessels (red) (courtesy of Lihong Wang, PhD); [6] optical micrograph of HeLa cells stained for microtubules (blue) and co-stained with DAPI for actin visualization (red); HeLa cells are the world's first stem cell line, originally derived from the aggressive cervical cancer cells of Henrietta Lacks (courtesy Tom Deerinck/NCMIR); [7] visualization of the pelvis highlighting the colon, which is imaged with contrast x-ray computed tomography (CT), and after digital surface rendering can be used in virtual colonoscopy, thus avoiding a physical visible light-based colonoscopy; [8] registered and fused sagittal 99mTc-sestamibi dedicated molecular single photon emission computed tomography (SPECT, heat color scale) and low-dose CT slice (gray scale) of a patient’s uncompressed, pendant breast containing two surgically confirmed DCIS loci in the posterior breast (courtesy of Martin Tornai, PhD); [9] classic, early x-radiograph of Wilhelm Röntgen’s wife’s hand (adapted from http://en.wikipedia.org/wiki/100_Photographs_that_Changed_the_World); [10] transverse pelvic CT (gray scale) with multiple superimposed simulated x-ray photon radiotherapy beams, and their cumulative 20Gy (red) deposited dose isocontours at the focus of a tumor (courtesy of Paul Read, MD, PhD); [11] false-colored scanning electron micrograph of human immunodeficiency virus (HIV) particles (yellow) infecting a human H9 T-cell (turquoise) (adapted from http://biosingularity.com/category/infection/); [12] transverse 18F-dopa positron emission tomography (PET) slice through a Parkinson patient’s brain showing decreased in vivo quantitative uptake in the right caudate and putamen (courtesy of Christaan Schiepers, MD, PhD); [13] registered and fused transverse head CT (gray scale) and registered superimposed PET image (color) of a patient immediately after radio-therapeutic proton irradiation showing endogenously created 15O-positron emitter (2 min half-life) within the nasopharyngeal tumor focus (courtesy of Kira Grogg, PhD). [14] transverse (long axis) cardiac 99mTc-sestamibi SPECT slice illustrating thinned myocardial apical wall in a procedure performed thousands of times daily around the world (adapted from www.medscape.com). These images are but a small sampling of the breadth of the spectrum of light that is currently being investigated the world over by passionate scientists and engineers on a quest for the betterment of the human condition. All contributors for these images used herein have given their permission for their use, and are graciously thanked.
Image by Martin Tornai
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
Video by University of California Television (UCTV)/YouTube
Virtual Colonoscopy Q&A | Dr. Karen Horton
Video by Johns Hopkins Medicine/YouTube
All Views
Inside
Outside
Unfurled
1
2
3
4
Virtual Colonoscopy
Virtual colonoscopy is a new technology that uses computerized tomography (CT) images to look for polyps and cancer in the colon. The result is a computer-generated, animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy is performed for removal or biopsy of the growth.
Interactive by TheVisualMD
UCSF Radiology: How is Virtual Colonoscopy Performed?
Video by UCSF Imaging/YouTube
Virtual Colonoscopy - Lexington Diagnostic Center
Video by Lexington Diagnostic Center/YouTube
Virtual Colonoscopy-Mayo Clinic
Video by Mayo Clinic/YouTube
3D Visualization of Colon and Virtual Colonoscopy
3D Visualization of Colon and Virtual Colonoscopy
Image by TheVisualMD
Virtual Colonoscopy 3D Model
TheVisualMD
Virtual Colonoscopy open colon section view
TheVisualMD
A Less Invasive Look
TheVisualMD
0:13
Colon unfurling
TheVisualMD
0:49
Colorectal Cancer Clip 3
TheVisualMD
0:15
Colorectal Cancer Clip 4
TheVisualMD
Spectrum of Medical Imaging
Martin Tornai
1:26:06
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
University of California Television (UCTV)/YouTube
8:26
Virtual Colonoscopy Q&A | Dr. Karen Horton
Johns Hopkins Medicine/YouTube
Virtual Colonoscopy
TheVisualMD
2:33
UCSF Radiology: How is Virtual Colonoscopy Performed?
UCSF Imaging/YouTube
2:24
Virtual Colonoscopy - Lexington Diagnostic Center
Lexington Diagnostic Center/YouTube
2:19
Virtual Colonoscopy-Mayo Clinic
Mayo Clinic/YouTube
3D Visualization of Colon and Virtual Colonoscopy
TheVisualMD
Sigmoidoscopy
Sigmoidoscopy
Also called: Flexible Sigmoidoscopy, Rigid Sigmoidoscopy, Proctoscopy, Proctosigmoidoscopy
A sigmoidoscopy is a diagnostic test used to check the sigmoid colon, which is the lower part of your colon or large intestine. It is used to help diagnose bowel problems and detect colon polyps that can become colon cancer.
Sigmoidoscopy
Also called: Flexible Sigmoidoscopy, Rigid Sigmoidoscopy, Proctoscopy, Proctosigmoidoscopy
A sigmoidoscopy is a diagnostic test used to check the sigmoid colon, which is the lower part of your colon or large intestine. It is used to help diagnose bowel problems and detect colon polyps that can become colon cancer.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative result means that no abnormalities were found in the colon. If you're at average risk of colon cancer, meaning you have no colon cancer risk factors other than age, your doctor may recommend repeating the exam in five years.
Related conditions
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Use the slider below to see how your results affect your
health.
Your result is Normal.
The lining of the colon appears smooth and pink, with numerous folds. No abnormal growths, pouches, bleeding, or inflammation is seen.
Related conditions
Sigmoidoscopy is a test in which the rectum and sigmoid colon are examined using a sigmoidoscope, a flexible lighted tube with a lens for viewing and a tool for removing tissue. This instrument is inserted through the anus into the rectum and sigmoid colon as air is pumped into the colon to expand it so the doctor can see the colon lining more clearly.
A sigmoidoscope is of two types:
Rigid sigmoidoscope: This sigmoidoscope is 25 cm long, and it allows examination of up to about 20 cm of the rectum and colon.
Flexible sigmoidoscope: It is made of a flexible fiber-optic tube and can be up to 60 cm long. It allows examination of the descending colon.
During sigmoidoscopy, abnormal growths in the rectum and sigmoid colon can be removed for analysis (biopsied). The lower colon must be cleared of stool before sigmoidoscopy, but the preparation is not very extensive. People are usually not sedated for this test.
You may need a sigmoidoscopy to find the cause of unexplained symptoms such as:
Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
Changes in your bowel activity, such as diarrhea
Pain in your abdomen (belly)
Unexplained weight loss
Doctors also use the procedure to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you at higher risk, you may need to start getting screened for colorectal cancer earlier.
There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.
This test allows your provider to look at the lower part of the colon. During the test:
You will lie on an exam table with your knees drawn up to your chest.
A sigmoidoscope, a flexible, lighted tube with a camera, will be inserted into the rectum and up into the lower part of the colon.
Air will be pumped through the sigmoidoscope to make the colon bigger and easier to see.
The air may make you feel like you need to have a bowel movement or pass gas.
Your provider may remove polyps or tissue samples using special tools inserted through the scope.
Polyps or samples may be sent to a lab for testing.
For a sigmoidoscopy, before the test, you may need to:
Follow a clear liquid diet one or more days before the procedure. This isn't always required, so be sure to talk to your provider before the test.
You may be asked to fast (not eat or drink) on the morning of the procedure.
Use an enema to empty your bowels about one hour before the procedure. A second enema is sometimes needed.
There are fewer risks to sigmoidoscopy than with a colonoscopy. Tears in the colon and bleeding can happen, but they are even less common than with a colonoscopy.
Normal findings are healthy intestinal tissues. Abnormal results may include the following:
Colorectal polyps or abnormal tissue were found. They may or may not be removed depending on their location.
Whether or not your polyps were removed, you will probably need a colonoscopy so your provider can view your entire colon and rectum.
If you have questions about your results, talk to your health care provider.
Tests to Detect Colorectal Cancer and Polyps - National Cancer Institute [accessed on Dec 28, 2018]
Colorectal Cancer Screening | Cancer Trends Progress Report [accessed on Dec 28, 2018]
Colorectal Cancer Screening (PDQ®)—Patient Version - National Cancer Institute [accessed on Dec 28, 2018]
Rigid and Flexible Sigmoidoscopy. MedicineNet [accessed on Feb 09, 2024]
Colorectal Cancer Screening Tests: MedlinePlus Medical Test [accessed on Feb 10, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (24)
Colorectal Cancer Screening
Video by Mechanisms in Medicine/YouTube
Testing for bowel cancer
Video by Cancer Research UK/YouTube
Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations
Image by TheVisualMD
Screening & Diagnosis
Image by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 1
Colorectal Cancer Clip 1
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 6
Colorectal Cancer Clip 6
Video by TheVisualMD
Colonoscopy or sigmoidoscopy testing
Drawing of a woman being tested for colon polyps. The woman is lying on her left side with her head on a pillow. In the background is a TV screen showing images of the colon.
Image by NIDDK Image Library
Drawing of the digestive system with sigmoid colon, rectum, and anus highlighted and parts labeled: esophagus, stomach, liver, gallbladder, duodenum, pancreas, small intestine, colon, sigmoid colon, rectum, and anus
The digestive system focusing on the sigmoid colon, rectum, and anus.
Image by NIDDK Image Library
colonoscopy
SAN DIEGO (April 5, 2011) Hospitalman Urian D. Thompson, left, Lt. Cmdr. Eric A. Lavery and Registered Nurse Steven Cherry review the monitor while Lavery uses a colonoscope on a patient during a colonoscopy at Naval Medical Center San Diego. (U.S. Navy photo by Mass Communication Specialist 2nd Class Chad A. Bascom/Released)
Image by U.S. Navy photo by Mass Communication Specialist 2nd Class Chad A. Bascom
Sensitive content
This media may include sensitive content
Diagram showing a colonoscopy
Diagram showing a colonoscopy.
Image by Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
normal rectum colonoscopy
normal rectum 70y.o. Japanese / colonoscopy
Image by melvil
Familial adenomatous polyposis as seen on sigmoidoscopy
Familial adenomatous polyposis as seen on sigmoidoscopy
Image by Samir
Proctoscopy
Two proctoscopes
Image by Ralf Lotys (Sicherlich)
An anoscope, a proctoscope and a rectoscope, with approximate lengths
An anoscope, a proctoscope and a rectoscope, with approximate lengths
Image by Mikael Häggström
This browser does not support the video element.
Sigmoidoscopy: NCI B-roll [video]
NCI B-roll of a patient receiving a sigmoidoscopy. This video is silent. A version of this video with audio can be found in the video NCI Detection B-roll. Downloadable video files are 1280x720 at 30 fps. This image is part of the NCI B-Roll Videos collection.
View video using embedded player on this page or at youtube.com.
Video by National Cancer Institute (NCI)
Lower GI Series
A lower GI series, also called a barium
enema, is an x-ray exam used to help
diagnose problems of the large intestine. An
x ray is a picture created by using radiation
and recorded on film or on a computer. To
make the large intestine more visible on x ray,
a health care provider will fill the person’s
intestine with a chalky liquid called barium.
Document by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Drawing of the digestive system with sigmoid colon, rectum, and anus highlighted
The digestive system focusing on the sigmoid colon and stomach.
Image by NIDDK Image Library
Benign Tumor
Image of en:familial adenomatous polyposis as seen on en:sigmoidoscopy.
Image by Samir at English Wikipedia
What is a flexible sigmoidoscopy?
Video by You and Colonoscopy/YouTube
Colon Cancer Screening Tests: Flexible Sigmoidoscopy
Video by American Cancer Society/YouTube
Colon cancer: Essential facts
Video by Institute for Cancer Genetics and Informatics/YouTube
Screening for Colorectal Cancer
Video by Dartmouth-Hitchcock/YouTube
What to expect during a colonoscopy
Video by MD Anderson Cancer Center/YouTube
6 Reasons to Get a Colonoscopy
Video by Cleveland Clinic/YouTube
2:42
Colorectal Cancer Screening
Mechanisms in Medicine/YouTube
1:37
Testing for bowel cancer
Cancer Research UK/YouTube
Screening for Cancer
TheVisualMD
Screening & Diagnosis
TheVisualMD
0:15
Colorectal Cancer Clip 1
TheVisualMD
0:05
Colorectal Cancer Clip 6
TheVisualMD
Colonoscopy or sigmoidoscopy testing
NIDDK Image Library
Drawing of the digestive system with sigmoid colon, rectum, and anus highlighted and parts labeled: esophagus, stomach, liver, gallbladder, duodenum, pancreas, small intestine, colon, sigmoid colon, rectum, and anus
NIDDK Image Library
colonoscopy
U.S. Navy photo by Mass Communication Specialist 2nd Class Chad A. Bascom
Sensitive content
This media may include sensitive content
Diagram showing a colonoscopy
Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
normal rectum colonoscopy
melvil
Familial adenomatous polyposis as seen on sigmoidoscopy
Samir
Proctoscopy
Ralf Lotys (Sicherlich)
An anoscope, a proctoscope and a rectoscope, with approximate lengths
Mikael Häggström
1:17
Sigmoidoscopy: NCI B-roll [video]
National Cancer Institute (NCI)
Lower GI Series
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Drawing of the digestive system with sigmoid colon, rectum, and anus highlighted
NIDDK Image Library
Benign Tumor
Samir at English Wikipedia
1:55
What is a flexible sigmoidoscopy?
You and Colonoscopy/YouTube
2:49
Colon Cancer Screening Tests: Flexible Sigmoidoscopy
American Cancer Society/YouTube
2:49
Colon cancer: Essential facts
Institute for Cancer Genetics and Informatics/YouTube
4:06
Screening for Colorectal Cancer
Dartmouth-Hitchcock/YouTube
1:16
What to expect during a colonoscopy
MD Anderson Cancer Center/YouTube
3:17
6 Reasons to Get a Colonoscopy
Cleveland Clinic/YouTube
Fecal Occult Blood Test
Fecal Occult Blood Test
Also called: FOBT, Stool Hemoccult, Hemoccult Test
A fecal occult blood test looks for blood in the stool. Occult blood means that you can't see it with the naked eye. And fecal means that it is in your stool. Blood in stool may indicate hemorrhoids, colorectal cancer, or another condition.
Fecal Occult Blood Test
Also called: FOBT, Stool Hemoccult, Hemoccult Test
A fecal occult blood test looks for blood in the stool. Occult blood means that you can't see it with the naked eye. And fecal means that it is in your stool. Blood in stool may indicate hemorrhoids, colorectal cancer, or another condition.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative test result means that there is no blood in the stool.
Related conditions
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative or normal result means the test did not detect any blood in the stool. However, because cancers in the colon may not always bleed, you may need to do the test a few times to confirm that there is no blood in your stool.
Related conditions
A fecal occult blood test (FOBT) looks at a sample of your stool (poop) to check for blood. Occult blood means that you can't see it with the naked eye. And fecal means that it is in your stool.
Blood in your stool means there is bleeding in the digestive tract. The bleeding may be caused by a variety of conditions, including:
Polyps, abnormal growths on the lining of the colon or rectum
Hemorrhoids, swollen veins in your anus or rectum
Diverticulosis, a condition with small pouches in the inside wall of the colon
Ulcers, sores in the lining of the digestive tract
Colitis, a type of inflammatory bowel disease
Colorectal cancer, a type of cancer that starts in the colon or rectum
Colorectal cancer is one of the most common types of cancer in the United States. A fecal occult blood test can screen for colorectal cancer to help find the disease early when treatment may be most effective.
Other names: FOBT, stool occult blood, occult blood test, Hemoccult test, guaiac smear test, gFOBT, immunochemical FOBT, iFOBT; FIT
A fecal occult blood test is commonly used as a screening test to help find colorectal cancer before you have symptoms. The test also has other uses. It may be done when there is concern about bleeding in the digestive tract from other conditions.
In certain cases, the test is used to help find the cause of anemia. And it can help tell the difference between irritable bowel syndrome (IBS), which usually doesn't cause bleeding, and inflammatory bowel disease (IBD), which is likely to cause bleeding.
But a fecal occult blood test alone cannot diagnose any condition. If your test results show blood in your stool, you will likely need other tests to diagnose the exact cause.
Your health care provider may order a fecal occult blood test if you have symptoms of a condition that could involve bleeding in your digestive tract. Or you may have the test to screen for colorectal cancer when you don't have any symptoms.
Expert medical groups strongly recommend that people get regular screening tests for colorectal cancer. Most medical groups recommend that you start screening tests at age 45 or 50 if you have an average risk of developing colorectal cancer. They recommend regular testing until at least age 75. Talk with your provider about your risk for colorectal cancer and when you should get a screening test.
A fecal occult blood test is one or several types of colorectal screening tests. Other tests include:
A stool DNA test. This test checks your stool for blood and cells with genetic changes that may be a sign of cancer.
Colonoscopy or sigmoidoscopy. Both tests use a thin tube with a camera to look inside your colon. A colonoscopy allows your provider to see your entire colon. A sigmoidoscopy shows only the lower part of your colon.
CT colonography, also called "virtual colonoscopy." For this test, you usually drink a dye before having a CT scan that uses x-rays to take detailed 3-dimensional pictures of your entire colon and rectum.
There are pros and cons of each type of test. Your provider can help you figure out which test is right for you.
Usually, your provider will give you a kit to collect samples of your stool (poop) at home. The kit will include instructions on how to do the test.
There are two main types of fecal occult blood tests:
The guaiac fecal occult blood test (gFOBT) uses a chemical (guaiac) to find blood in stool. It usually requires stool samples from two or three separate bowel movements.
The fecal immunochemical test (iFOBT or FIT) uses antibodies to find blood in stool. Research shows that FIT testing is better at finding colorectal cancers than gFOBT testing. A FIT test requires stool samples from one to three separate bowel movements, depending on the brand of the test.
Different test kits have different instructions, so it's very important to follow the specific instructions that come with your kit. The typical process for gathering a stool sample usually includes these general steps:
Collecting a bowel movement. Your kit may include a special paper to place over your toilet to catch your bowel movement. Or you may use plastic wrap or a clean, dry container. If you are doing a guaiac test, be careful not to let any urine mix in with your stool.
Taking a stool sample from the bowel movement. Your kit will include a wooden stick or applicator brush for scraping the stool sample from your bowel movement. Follow the instructions for where to gather the sample from the stool.
Preparing the stool sample. You will either smear the stool on a special test card or insert the applicator with the stool sample into a tube that came with your kit.
Labeling and sealing the sample as directed.
Repeating the test on your next bowel movement as directed if more than one sample is needed.
Returning the samples as directed. This might be mailing them or taking them to your provider's office or a lab.
You do not need any special preparations for many fecal occult blood tests. But for some guaiac fecal occult blood tests (gFOBTs), certain foods, supplements, and medicines may affect the results of the test. If you are having one of these tests, your provider will tell you what you need to avoid and for how long. For example, you might need to avoid:
Nonsteroidal, anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and aspirin. If you take aspirin for heart problems, talk with your provider before stopping your medicine. You may be able to take acetaminophen during this time but check with your provider before taking it.
Vitamin C in amounts over 250 mg a day. This includes vitamin C from supplements, fruit juices, or fruit.
Red meat, such as beef, lamb, and pork. Traces of blood from these meats may show up in your stool.
Certain raw fruits and vegetables.
There is no known risk to having a fecal occult blood test.
If your results from a fecal occult blood test show that you have blood in your stool, it means you likely have bleeding somewhere in your digestive tract. But that doesn't always mean you have cancer. Other conditions that may cause blood in your stool include ulcers, hemorrhoids, polyps, and benign (not cancer) tumors.
If you have blood in your stool, your provider will likely recommend more tests to figure out the exact location and cause of your bleeding. The most common follow-up test is a colonoscopy. If you have questions about your test results, talk with your provider.
Learn more about laboratory tests, reference ranges, and understanding results.
Regular colorectal cancer screenings, such as fecal occult blood tests, are an important tool in the fight against cancer. Studies show that screening tests can help find cancer early and may reduce deaths from the disease.
If you decide to use fecal occult blood testing for your colorectal cancer screening, you will need to do the test every year.
You can buy gFOBT and FIT stool collection kits without a prescription. Most of these tests require you to send a sample of your stool to a lab. But some tests can be done completely at home for quick results. If you're considering buying your own test, ask your provider which one is best for you.
Fecal Occult Blood Test (FOBT): MedlinePlus Lab Test Information [accessed on Dec 28, 2018]
Tests to Detect Colorectal Cancer and Polyps - National Cancer Institute [accessed on Dec 28, 2018]
Additional Materials (4)
Colorectal Cancer Types of Surgery
Surgery is the main treatment for colorectal cancer. Polyps and very early stage cancers (Stage 0 and some early Stage I tumors) can be removed during a colonoscopy, using a variety of techniques. In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied. If it isn't possible to perform a resection (for instance, if the cancer is at the outlet of the rectum), a colostomy may be performed. In a colostomy, a portion of the large intestine is brought through the abdominal wall to carry stool out of the body, where it empties into a special bag. The colostomy may be temporary in order to allow the colon or rectum time to heal after surgery, or it may be permanent.
Image by TheVisualMD
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Colorectal Cancer Screening & Diagnosis
Colorectal cancer includes cancer of both the colon and rectum. It is the fourth most common cancer in the United States and the second leading cause of cancer-related deaths affecting both men and women equally. The CDC recommends that everyone age 50 or over be screened. When diagnosed early, patients have a 90% 5-year survival rate.
Video by TheVisualMD
Screening and Diagnosis Fecal Occult Blood Test
A fecal occult blood test (FOBT) finds blood in the stool by placing a stool sample on a chemically treated card, pad, or cloth wipe. A fecal occult blood test may be used to check for colorectal cancer, but it is never used to diagnose the condition.
Image by TheVisualMD
Fecal impaction
Fecal impaction : Plain abdominal X-ray showing a huge fecal impaction extending from the pelvis upwards to the left subphrenic space and from the left towards the right flank, measuring over 40 cm in length and 33 cm in width.
Image by Di Saverio S, Tugnoli G, Orlandi PE, Casali M, Catena F, et al.
Colorectal Cancer Types of Surgery
TheVisualMD
4:12
Colorectal Cancer Screening & Diagnosis
TheVisualMD
Screening and Diagnosis Fecal Occult Blood Test
TheVisualMD
Fecal impaction
Di Saverio S, Tugnoli G, Orlandi PE, Casali M, Catena F, et al.
Low-Dose Computed Tomography
Low-Dose Computed Tomography
Also called: LDCT, Low-Dose CT Scan, Lung Cancer Screening with Low-Dose CT
Lung cancer screening with low-dose computed tomography is recommended only for adults who have no symptoms but are at high risk for developing the disease because of their smoking history and age. In this test, an X-ray machine scans the body and uses low doses of radiation to make detailed pictures of the lungs.
Low-Dose Computed Tomography
Also called: LDCT, Low-Dose CT Scan, Lung Cancer Screening with Low-Dose CT
Lung cancer screening with low-dose computed tomography is recommended only for adults who have no symptoms but are at high risk for developing the disease because of their smoking history and age. In this test, an X-ray machine scans the body and uses low doses of radiation to make detailed pictures of the lungs.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative result means nothing abnormal was seen on the scan. Ask your care team when and if you should repeat the scan based on your health and history. False-negative test results can occur, meaning the scan may appear to be normal even though lung cancer is present.
Related conditions
Who Should Be Screened for Lung Cancer? | CDC [accessed on Jan 07, 2019]
Decision Memo for Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) (CAG-00439N) [accessed on Jan 07, 2019]
Lung Cancer Screening With Low-Dose CT (LDCT) FAQs [accessed on Jan 07, 2019]
Lung Cancer Screening [accessed on Jan 07, 2019]
PDQ® Screening and Prevention Editorial Board. PDQ Lung Cancer Screening. Bethesda, MD: National Cancer Institute. [accessed on Jan 07, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
What Are Standard Tests?
When Things Go Wrong
Image by TheVisualMD
When Things Go Wrong
Image by TheVisualMD
How Do Screening Tests Become Standard Tests?
Results from research studies help doctors decide when a screening test works well enough to be used as a standard test.
Evidence about how safe, accurate, and useful cancer screening tests are comes from clinical trials (research studies with people) and other kinds of research studies. When enough evidence has been collected to show that a screening test is safe, accurate, and useful, it becomes a standard test. Examples of cancer screening tests that were once under study but are now standard tests include:
Colonoscopy for colorectal cancer.
Mammograms for breast cancer.
Pap tests (Pap smears) for cervical cancer.
Different types of research studies are done to study cancer screening.
Cancer screening trials study new ways of finding cancer in people before they have symptoms. Screening trials also study screening tests that may find cancer earlier or are more accurate than existing tests, or that may be easier, safer, or cheaper to use. Screening trials are designed to find the possible benefits and possible harms of cancer screening tests. Different clinical trial designs are used to study cancer screening tests.
The strongest evidence about screening comes from research done in clinical trials. However, clinical trials cannot always be used to study questions about screening. Findings from other types of studies can give useful information about how safe, useful, and accurate cancer screening tests are.
The following types of studies are used to get information about cancer screening tests:
Randomized controlled trials
Randomized controlled trials give the highest level of evidence about how safe, accurate, and useful cancer screening tests are. In these trials, volunteers are assigned randomly (by chance) to one of two or more groups. The people in one group (the control group) may be given a standard screening test (if one exists) or no screening test. The people in the other group(s) are given the new screening test(s). Test results for the groups are then compared to see if the new screening test works better than the standard test, and to see if there are any harmful side effects.
Using chance to assign people to groups means that the groups will probably be very much alike and that the trial results won't be affected by human choices or something else.
Nonrandomized controlled trials
In nonrandomized clinical trials, volunteers are not assigned randomly (by chance) to different groups. They choose which group they want to be in or the study leaders assign them. Evidence from this type of research is not as strong as evidence from randomized controlled trials.
Cohort studies
A cohort study follows a large number of people over time. The people are divided into groups, called cohorts, based on whether or not they have had a certain treatment or been exposed to certain things. In cohort studies, the information is collected and studied after certain outcomes (such as cancer or death) have occurred. For example, a cohort study might follow a group of women who have regular Pap tests, and divide them into those who test positive for the human papillomavirus (HPV) and those who test negative for HPV. The cohort study would show how the cervical cancer rates are different for the two groups over time.
Case-control studies
Case-control studies are like cohort studies but are done in a shorter time. They do not include many years of follow-up. Instead of looking forward in time, they look backward. In case-control studies, information is collected from cases (people who already have a certain disease) and compared with information collected from controls (people who do not have the disease). For example, a group of patients with melanoma and a group without melanoma might be asked about how they check their skin for abnormal growths and how often they check it. Based on the different answers from the two groups, the study may show that checking your skin is a useful screening test to decrease the number of melanoma cases and deaths from melanoma.
Evidence from case-control studies is not as strong as evidence from clinical trials or cohort studies.
Ecologic studies
Ecologic studies report information collected on entire groups of people, such as people in one city or county. Information is reported about the whole group, not about any single person in the group. These studies may give some evidence about whether a screening test is useful.
The evidence from ecologic studies is not as strong as evidence from clinical trials or other types of research studies.
Expert opinions
Expert opinions can be based on the experiences of doctors or reports of expert committees or panels. Expert opinions do not give strong evidence about the usefulness of screening tests.
Source: National Cancer Institute (NCI)
Additional Materials (18)
Screening & Diagnosis
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Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations Breast cancer
Mammography: Women 40 and older should have a mammogram every year.
Clinical breast exam (breast exam performed by a medical professional): Women age 20-40 should have one every 3 years. Women 40 and older should have one every year.
Breast self-exam: Women age 20 and older should perform one each month (considered optional).
If you have a family history of breast cancer, talk to your healthcare professional about what type of screening you should have, and how often.
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Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations
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Screening for Cancer
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Cancer Biopsy
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Prostate Cancer Screening and Detection
Prostate Cancer Screening and Detection
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When Things Go Wrong
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Thermography of breast
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Cancer Biopsy
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Benefits and Harms of LDCT Screening for Lung Cancer
The benefits of lung cancer screening may be greater if your lung cancer risk is higher. For example, current smokers who smoke more than one pack a day have a higher risk for lung cancer than smokers who quit 10 years ago.
The harms of lung cancer screening may be greater if you have other health problems, such as heart disease or severe lung disease like asthma or chronic obstructive pulmonary disease (COPD). The risk of problems from biopsies may be higher in these people.
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Colorectal Cancer Screening: When, How, and Who?
With its Screen to Save initiative, the National Cancer Institute's Center to Reduce Cancer Health Disparities aims to increase colorectal cancer screening rates among men and women age 50 and older from racially and ethnically diverse communities and in rural areas.
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Nurse examines mammogram image of patient during exam.
Mammograms are still the best primary tool for breast cancer screening. To continue to protect women's health, the FDA is proposing updates to the mammography regulations to reflect advances in mammography technology and processes.
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Breast Self-Exam (3 Methods)
Breast Self-Exam (3 Methods)
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Colorectal Cancer Screening: When, How, and Who?
With its Screen to Save initiative, the National Cancer Institute's Center to Reduce Cancer Health Disparities aims to increase colorectal cancer screening rates among men and women age 50 and older from racially and ethnically diverse communities and in rural areas.
Image by National Cancer Institute (NCI)
Fecal immunochemical test
A fecal immunochemical test for the detection of occult blood in stool, commonly used for colorectal cancer screening
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Cologuard box
A Cologuard colorectal screening test package, ready for return to Exact Sciences.
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Bowel cancer Home Test Kit package in Australia
Bowel cancer Home Test Kit package in Australia
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Genetic Testing and Cancer Screening
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TheVisualMD
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TheVisualMD
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TheVisualMD
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Screening for Cancer
TheVisualMD
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Cancer Biopsy
TheVisualMD
Prostate Cancer Screening and Detection
TheVisualMD
When Things Go Wrong
TheVisualMD
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Thermography of breast
FDA
Cancer Biopsy
TheVisualMD
Benefits and Harms of LDCT Screening for Lung Cancer
Agency for Healthcare Research and Quality (AHRQ)
Colorectal Cancer Screening: When, How, and Who?
National Cancer Institute (NCI)
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Nurse examines mammogram image of patient during exam.
U.S. Food and Drug Administration (FDA)
Breast Self-Exam (3 Methods)
Blausen Medical Communications, Inc.
Colorectal Cancer Screening: When, How, and Who?
National Cancer Institute (NCI)
Fecal immunochemical test
Cbalentine/Wikimedia
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Gnesener1900/Wikimedia
Bowel cancer Home Test Kit package in Australia
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18:17
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Columbia University Department of Surgery/YouTube
Risks of Overscreening
Many Older Adults Screened Unnecessarily for Common Cancers
Many older adults are being screened for cancer who no longer need to be, results from a new study show.
Based on a nationwide survey, the study found that at least half of older adults had received at least one unnecessary cancer screening test in the previous few years.
The United States Preventive Services Task Force (USPSTF) recommends that people at average risk of cancer get colorectal cancer screening through age 75, breast cancer screening through age 74, and cervical cancer screening through age 65.
Many older adults are undergoing unnecessary cancer screenings, a new study shows. Credit: iStock
In general, above those ages, people have a greater likelihood of being harmed by than benefiting from these tests, explained Barry Kramer, M.D., M.P.H., of NCI’s Division of Cancer Control and Population Sciences, who was not involved in the study.
The term "overscreening" is used to describe the use of such tests past the point where they are likely to provide a net benefit.
People often aren’t aware that there are potential harms from cancer screening, explained Jennifer Moss, Ph.D., from Penn State University, who led the new study, which was funded in part by NCI and published July 27 in JAMA Network Open. These harms can include false-positive test results that lead to unnecessary follow-up procedures.
“But what we’re particularly worried about for older adults is the harm from the test itself. All of these screening tests are medical procedures that have potential side effects,” Dr. Moss said. This risk of harm is highest for invasive tests, such as colonoscopy.
Studies have shown that the overall benefits of screening, such as detecting cancer earlier when it's potentially easier to treat, outweigh the likelihood of harms in younger adults. However, the harms increase as people age.
Screening tests usually pick up slower growing cancers. “For some tests, it can take 10 to 15 years, or even more, to reveal their benefits. The older you are, the less likely you are to reap those benefits,” said Dr. Kramer. As people grow older, the more they are likely to die of another cause before a cancer that might have been detected early on a screening test would have caused symptoms.
“The harms, however, are front-loaded: they often occur at the time of the test or shortly thereafter,” he said.
“That's why these recommendations are in place, to make sure that people who get screened are going to benefit and that the likelihood of the risks or harms are minimized to the extent possible,” Dr. Moss added.
Widespread Testing, Regardless of Health
Reports from single hospitals have suggested that many older adults are getting overscreened. To get a better idea of these trends nationwide, Dr. Moss and her colleagues used data collected in 2018 by the Behavioral Risk Factor Surveillance System, a yearly national survey conducted by the Centers for Disease Control and Prevention.
They reviewed survey responses from more than 175,000 older women and men whose average age was 75 and recorded the ages at which participants last reported receiving cancer screening tests. They also looked at whether participants lived in a metropolitan area, because access to cancer screening can differ between urban and rural regions.
The researchers also used self-reported health information from the survey to estimate participants’ risk of dying from any cause within the next 10 years.
More than 80% of survey participants lived in a metropolitan area, and almost three-quarters reported good, very good, or excellent health.
Most participants reported having been screened for one or more cancer types “after they had ‘aged out’ of the recommended range for routine cancer screening,” said Dr. Moss. “We found that overscreening was incredibly common. Overall, 45% to 75% of older adults were getting these tests [past the recommended age].”
Fifty-nine percent of men reported being screened for colorectal cancer after the age where they would be expected to benefit. And most women reported being overscreened for one or more cancer types: 74% for breast cancer, 56% for colorectal cancer, and 46% for cervical cancer.
Women who lived in metropolitan areas were more likely to be overscreened for each of these cancers than those in rural communities. The same was not true for men, however.
Because of the limited availability of hospitals and other health care facilities, people who live in rural areas often have challenges getting screened. While this can reduce overscreening, it can also prevent people from getting appropriate screening tests when needed, the study authors explained. Why this trend wasn’t seen for colorectal cancer screening in men in this study was not clear.
People’s projected life expectancy did not seem to influence whether or not they received screening tests.
“We expected that as mortality risk was higher, and therefore life expectancy was lower, that people would not be overscreened as much,” Dr. Moss said. “But we didn't see a lot of evidence for that. It doesn't appear that someone's overall health really influences this decision…so that was surprising.”
Testing Beyond Screening
The USPSTF recommendations—and most recommendations from professional societies—are for people at average risk of cancer. The survey did not ask whether participants had an increased risk of cancer. For example, people with some inherited gene mutations, or with a family history of cancer, may be encouraged to continue screening at older ages.
“And if you’ve had cancer in the past, or had abnormal results on [previous] cancer screening tests, there are different guidelines for whether or not you should continue getting screened and for how long you should continue getting screened,” explained Dr. Moss. But such people were likely a minority in the current study, she added.
The data also didn’t capture if a test was done because someone reported symptoms. Those types of diagnostic tests remain vital, no matter someone’s age, explained Dr. Kramer.
Even during the current pandemic, if you find a lump or experience bleeding or other concerning symptoms, “get to your doctor,” he said. “That’s not screening—that’s workup of a potentially serious problem.”
But overall, the study results highlight that better education about cancer screening in older adults is needed, for both clinicians and the public, said both Dr. Moss and Dr. Kramer.
“When we hear public service announcements or people talking generally about cancer screening, we don't hear a lot about the age when you should stop getting screened,” Dr. Moss said. Among both clinicians and the public, she continued, “I think that there's pretty low awareness of when older adults should graduate out of screening.”
“Many practitioners are not aware of what the guidelines are,” agreed Dr. Kramer. But also, he added, conversations about stopping screening are difficult ones, particularly if a clinician has a long-term relationship with someone.
“A physician who for years has been ordering tests for their patients may find it very difficult to say, 'You've reached the point where you're not likely to live long enough [to benefit],’” he said.
A Need for Informed Decision-Making
It’s also likely that a subset of older adults with good health and longer life expectancy would benefit from continued screening, but it’s not yet clear exactly who those people are, said Dr. Moss. More research is needed in this area, she added.
“When estimating the balance between benefits and harms, there’s often an upper age range. But that age range, the upper limit, is not fixed in stone as years go by,” said Dr. Kramer.
More research is also needed into when and how to have conversations about stopping screening, added Dr. Moss.
“There's a lot that we can learn from practice around lung cancer screening and prostate cancer screening,” she said. “Both of those screening tests are not really recommended for everyone who walks through the door. You're supposed to talk to your provider about whether or not it's appropriate for you, what your risks are, and what would the risks be of the test itself.
“We’ve done some focus groups with older adults about how people would want to talk about stopping screening with their provider,” she explained. “And a lot of older adults are really willing to [have these conversations]. They want information that’s very targeted to them and their personal health risks.”
Source: National Cancer Institute (NCI)
Putting Cancer Screening in Perspective
Putting Cancer Screening in Perspective
By Paul Pinsky, Ph.D., Chief, Early Detection Research Group, NCI Division of Cancer Prevention; Philip Castle, Ph.D., M.P.H., Director, NCI Division of Cancer Prevention; Maureen Johnson, Ph.D., Executive Secretary, President’s Cancer Panel; and Samantha Finstad, Ph.D., Senior Health Science Policy Advisor, President’s Cancer Panel
It’s common wisdom that “catching the cancer early” is always a good thing. It can be a key factor in being able to survive cancer. You often hear, “luckily, they caught it early,” or the converse, “unfortunately, they didn’t detect it until it had spread” when people talk about friends or relatives with a cancer diagnosis. But the reality of cancer screening is not that simple.
The overall goal of cancer screening is to reduce cancer morbidity (illness) and mortality (death). There is no question that appropriate screening reduces illnesses and deaths due to cancer. Cervical and colorectal cancer incidence has declined in the last few decades by about 55% and 45%, respectively. Death rates have declined even more. These have been due primarily to routine screening.
Some types of screenings can detect cancer early (e.g., mammography for breast cancer and low-dose CT for lung cancer). Others can detect cancer early as well as detect cancer precursors, which can prompt action to prevent the development of cancer (e.g., colonoscopy screening for colorectal cancer and Pap smears and/or HPV testing for cervical cancer). Preventing cancer, even a curable cancer, is a large benefit in itself because it can reduce the many burdens to patients associated with a cancer diagnosis.
But when communicating information about cancer screenings to the public, it’s important to discuss the benefits and the risks. Cancer screening will not necessarily benefit every patient who gets it. A patient could still succumb to cancer despite it being detected early. Others may survive even if their cancer was missed early on and caught at a later stage. And for some patients, screening can actually cause harms.
Screening may lead to the overdiagnosis of indolent (symptomless) cancers. These are cancers detected through screening that would never have become symptomatic in the patient’s lifetime. There is evidence of overdiagnosis associated with various types of screening, most notably PSA screening for prostate cancer. Overdiagnosis of cancer can lead to treatment, or overtreatment, and have serious side effects. For example, impotence and urinary incontinence are associated with prostate cancer surgery.
Screening can also lead to false positives—when people get a positive screening test but no cancer is found. Since screening tests are usually given to healthy people with a low risk of harboring cancer, the tests need to have a high specificity, or the ability to avoid too many false-positive results. A false-positive result can cause anxiety, require additional clinical visits and diagnostic procedures like imaging and biopsies, and lead to high costs for both the medical system and patient. For example, for mammography screening, around 8−12% of women will receive a false positive result at any given screening visit, and up to 45% will receive at least one false positive result over a ten year period of regular screening.
Since cancer screening is intended for those who have no signs or symptoms of cancer, it is important that the benefits strongly outweigh the risks. Cancer screening guidelines can change as new research shows which populations would benefit most from screening with the least harm. For example, more people became eligible for lung cancer screening in 2021, when the U.S. Preventive Services Task Force updated their eligibility recommendations, lowering the minimum age and the amount a person has smoked over their lifetime (or smoking pack-years).
For new screening approaches, establishing the high sensitivity of a test—the ability to find someone who does have cancer—is an important first step in determining its clinical utility. But it is only a first step. Researchers must also demonstrate that the benefits outweigh the harms. Such evidence generally requires a randomized clinical trial in which subjects are randomized to a screening and control arm. The primary outcome is typically mortality from the cancer in question.
There is much discussion lately about the new “multi-cancer early detection” (MCED) tests. Also called liquid biopsies, these are blood tests that can detect multiple different cancer types simultaneously. To date, there has been limited research on the clinical utility of such tests—in other words, if they actually reduce illness and death. As these tests develop, it’s crucial to keep in mind that a sensitive test does not necessarily indicate clinical utility, or that the benefits of MCED screening would outweigh the harms.
While the benefits of appropriate screening are undeniable, it is important to acknowledge that harms can also be associated with screening; more is not always better. When describing cancer screening, make sure to refer to the current guidelines and clarify that screening isn’t for everyone. It should be done only for the right people at the right time.
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Cancer Screening
Cancer screening is looking for cancer at an early stage before a person has any symptoms. It can be a key factor in being able to survive cancer. When abnormal tissue or cancer is found early, it may be easier to treat or cure. Read more about the benefits and risks of cancer screening tests.