It’s autumn! It’s the time of year when the media likes to remind us about preventive cancer screenings. October is known as “Breast Cancer Awareness Month.” And hot on its heels is November, also known as “Movember,” to remind men to screen for cancers affecting men, like prostate and testicular cancers.

Arbitrary timing aside, the awareness raised during these months has helped save lives. The cancer death rate in the United States has fallen 34% since its peak in 1991, which translates to an estimated 4.8 million cancer deaths averted through 2023. Better treatments deserve plenty of credit, but prevention and earlier detection have played an important role too.

At Amaze, we believe in staying on top of preventive screenings all year long. But since the season has made cancer prevention top of mind, we thought it would be a perfect time to offer an update on recommendation and rule changes around cancer screenings. These kinds of changes can affect our ability to get low-cost/no-cost screenings, so they are worth knowing.

Screening Is Not One-Size-Fits-All

The most important thing to know is that cancer screening guidelines are written primarily for people at average risk. That phrase matters.

Your personal schedule may look very different if you have a strong family history of a particular cancer, certain genetic mutations, previous precancerous growths or cancer, inflammatory bowel disease, a significant smoking history, or other risk factors.

That’s why knowing your family history is more than an interesting conversation at Thanksgiving. If your mother had breast cancer at 42, your father had colon cancer at 50, or several relatives had the same or related cancers, tell your medical provider. You may need to begin screening earlier, screen more frequently, or consider genetic counseling. You can find a comprehensive list of risk factors for different types of cancer here.

For everyone else, here’s where things stand in 2026.

Official Recommendations Versus Best Practices

The most important thing to understand is the difference between government recommendations and health organization recommendations. Government recommendations come from the U.S. Preventive Services Task Force (USPSTF). They are the ones most often updated and generally represent the minimum number of preventive screenings insurers and government programs will cover for any individual.

The USPSTF generally recommends fewer and later screenings than health research organizations like the American Cancer Society. These organizations are dedicated to reducing cancer rates and tend to be more aggressive about prevention. The difference between the two sets of recommendations is a gray area where preventive screenings can cost you unnecessarily if you don’t plan ahead.

The most important thing to know is that a prescription from a healthcare provider can make a huge difference. At Amaze, we are happy discuss your history and risk factors and give you the support you need.

Breast Cancer: Start at 40, But How Often Is Still Up for Debate

This is where competing recommendations can make perfectly reasonable people want to throw up their hands.

The U.S. Preventive Services Task Force recommends a mammogram every two years from ages 40 through 74 for women at average risk. The American Cancer Society is somewhat more aggressive: women 40 through 44 should have the option of annual mammograms, women 45 through 54 should have them every year, and women 55 and older can switch to every other year or continue annually.

Which is right?

Both are based on evidence. They simply weigh the benefits of finding more cancers against the downsides of additional testing, false alarms, and overdiagnosis somewhat differently.

Our advice is simpler: at 40, have the conversation and start getting mammograms. Then work with your medical provider to decide whether annual or every-other-year screening makes sense for you.

And if you have dense breasts, pay attention to the notification that comes with your mammogram. Dense breast tissue both increases breast cancer risk and makes cancers harder to see on a mammogram. That does not automatically mean everyone with dense breasts needs an ultrasound or MRI. The USPSTF says there still isn’t enough evidence to recommend supplemental ultrasound or MRI routinely after a normal mammogram solely because a woman has dense breasts. Your other risk factors matter.

Colorectal Cancer: More Choices, and Some Better Billing Rules

Here is one area where a lot has changed.

For adults at average risk, colorectal cancer screening should begin at 45. That hasn’t changed. What has changed is the menu.

The American Cancer Society updated its colorectal cancer screening guideline in 2026. Colonoscopy and stool-based testing remain preferred approaches, but blood test screening is now an option for people who otherwise would not get screened. The important caveat is that blood testing is not a preferred screening method because it is less effective at detecting precancerous polyps and early Stage I cancers.

That distinction matters because a colonoscopy can do something most cancer screening tests cannot: prevent the cancer it is looking for. If the doctor finds a precancerous polyp during the procedure, it can usually be removed right then, before it ever has a chance to become cancer.

And if you prefer an at-home stool test, that’s fine. The best screening test is one you will actually complete. Just understand that a positive stool test isn’t the end of the screening. It needs to be followed by a colonoscopy.

Now for some welcome news about the bill.

For years, people could dutifully do a preventive stool test, get an abnormal result, and then discover that the necessary follow-up colonoscopy was being treated as a diagnostic procedure with a deductible or coinsurance attached. Federal guidance has now made clear that for most ACA-compliant private health plans, the follow-up colonoscopy is part of the preventive screening process and must be covered without cost sharing. If you hear otherwise, it means that the facility hosting the colonoscopy has not updated its billing to match the new guidelines.

There was another maddening loophole: You went in for a “free” screening colonoscopy, the doctor found a polyp, removed it, and suddenly the procedure could be treated differently for billing purposes. New federal guidance makes clear that private plans subject to the ACA preventive care requirements should not impose cost sharing simply because a polyp is discovered and removed during an in-network screening colonoscopy.

Medicare is a little different. Congress has been phasing out Medicare cost sharing when a polyp is removed during a screening colonoscopy, but that phaseout is not complete until 2030. So, if you are on Medicare, it’s still worth asking about your expected costs before the procedure.

In other words, we’ve closed some of the colonoscopy billing loopholes, but perhaps haven’t yet achieved the dream of making colonoscopy billing as easy to understand as the colonoscopy itself.

Cervical Cancer: The Pap Test Is No Longer the Whole Story

This may be the biggest screening change most people haven’t heard about.

Cervical cancer is unusual because we know what causes nearly all cases: persistent infection with certain high-risk types of human papillomavirus, or HPV. That means instead of simply looking for abnormal cervical cells with a Pap test, we can look directly for the virus that causes those changes.

The American Cancer Society recommends beginning cervical cancer screening at 25, with primary HPV testing every five years as the preferred approach.

Newly updated federal guidance says that beginning at 30, primary high-risk HPV testing every five years will be preferred, with Pap/HPV co-testing every five years or Pap testing every three years remaining alternatives. Those updated insurance requirements take effect for most plans beginning in 2027.

And here’s the genuinely new part: women ages 30 through 65 at average risk can now be offered self-collection for HPV testing. Instead of a clinician collecting the sample during a pelvic exam, a patient can collect her own vaginal sample for an approved HPV test. Evidence shows this can be an effective screening option and could be particularly useful for people who have avoided screening because of discomfort, access, or other barriers.

This does not mean the Pap test has disappeared. It means cervical screening is increasingly becoming HPV screening, with follow-up testing determined by what the HPV test finds.

And remember: the HPV vaccine prevents the infections responsible for most cervical cancers and several other cancers. Screening and vaccination work together; one doesn’t replace the other.

Lung Cancer: Former Smokers, Don’t Assume You’re Off the Hook

Lung cancer remains the leading cause of cancer death in the United States. The good news is that screening can find lung cancer earlier, when treatment has a much better chance of working.

The standard screening test is an annual low-dose CT scan, not a chest X-ray.

The USPSTF recommends annual screening for people ages 50 through 80 who have at least a 20 pack-year smoking history and currently smoke or quit within the past 15 years. The American Cancer Society goes further and no longer uses the “quit within 15 years” cutoff. Under its guideline, an otherwise healthy former smoker with the required smoking history may remain a candidate for screening no matter how long ago they quit.

That makes this one particularly worth discussing with your medical provider because screening recommendations and insurance coverage may not line up perfectly.

Prostate Cancer: A Conversation, Not an Automatic Test

With Movember approaching, this is a good time to clear up another common misconception.

There isn’t a universal recommendation that every man automatically receive an annual PSA test beginning at a certain birthday.

The PSA blood test can help detect prostate cancer, but PSA can also rise for reasons that have nothing to do with cancer. And prostate cancer is often so slow-growing that detecting and treating every case can expose men to biopsies and treatments they may never have needed.

For men at average risk, the American Cancer Society recommends discussing PSA screening with a medical provider beginning at 50. Men at higher risk, including Black men and men with a father or brother diagnosed with prostate cancer before 65, should begin that conversation at 45, and some men with multiple close relatives diagnosed young should start at 40.

The important word here is conversation. Your age, family history, overall health, and preferences should determine whether PSA screening makes sense for you.

What About Skin Cancer?

Check your skin (Demystifying Self Skin Checks). Know your moles. Pay attention to anything new, changing, bleeding, or refusing to heal. And people at particularly high risk may benefit from regular examinations by a dermatologist.

But unlike mammography or colorectal screening, there isn’t currently enough evidence for the USPSTF to recommend routine clinician skin cancer screening for every asymptomatic adult at average risk.

However, if you stay on top of your own skin changes and see anything at all that concerns you, a visit to a dermatologist should be covered. Check with a medical provider and your insurance. But most insurance will honor an in-network referral for a skin check for anything concerning.

The Bottom Line

Cancer screening recommendations can feel confusing because they change. But that’s actually a good thing. They change because we learn more about who benefits from screening, how often we need to do it, and which tests work best.

And increasingly, we have choices.

You may be able to screen for colon cancer at home. You may be able to collect your own HPV sample. You and your provider may decide that your mammogram should be yearly rather than every other year, or that your family history means you should begin screening earlier than everyone else.

The goal isn’t to memorize a screening chart.

The goal is to know your risk, know which screenings apply to you, and actually get them done.

October’s pink ribbons are a very good reminder. Use them to schedule your mammogram if you’re female and you’re due. Then take another five minutes and ask yourself what else on your cancer screening list you’ve been putting off.

Because the test you schedule may find nothing at all. And that’s a pretty wonderful result.