"The science of prevention and screening has changed," says John Santa, MD, MPH, director of the Consumer Reports Health Ratings Center. He oversaw the project.
"Consumers need to know that some screening tests are terrific, some are not good, and some can harm you," Santa says.
"We are not talking about people at high risk," he says. "And of course they are not symptomatic. We're not talking about what you should do if you have a mole that is changing or if you feel a breast lump."
The full report is in the March issue of Consumer Reports.
To develop the ratings, Santa and his team looked at medical research, consulted medical experts, surveyed more than 10,000 readers, and talked with patients about screening tests.
They looked closely at recommendations of the U.S. Preventive Services Task Force. This independent panel provides guidelines on health care based on evidence. Much of Consumer Reports' recommendations follow the task force guidelines to the letter. But, their recommendations sometimes differ from those of organizations such as the American Cancer Society (ACS). Here, details on the three recommended tests:
Cervical cancer. Women 21 to 30 should have a Pap smear to test for cervical cancer every three years. Women 30 to 65 can wait five years if they have had testing for human papillomavirus (HPV), the virus that causes the cancer. Those 65-plus can skip screening if they were screened regularly earlier. Those under 21 can also skip the test, as experts know the cancer is not common at those ages.
Colon cancer. Those 50 to 75 should get screened regularly, and older people should discuss the pros and cons with their doctor and decide. Options include a colonoscopy, which examines the entire colon, every 10 years, or a sigmoidoscopy, which looks at the lower third, every five years plus a stool test every three years, or an annual stool test. As far as other guidelines, no groups suggest screening younger than 50 unless high risk. The ACS also doesn't say to specifically stop at age 75.
Breast cancer. Women 50 to 75 need a mammogram every two years. Those 40 to 49 or 75 and older should talk with their doctor about pros and cons. These guidelines do split with those of the ACS, though. The cancer society recommends yearly mammograms after age 40 and as long as healthy.