Age-Based Screening Schedule: Pap Test, Mammogram & Colonoscopy

Preventive screenings are one of the simplest ways to protect your long-term health, especially when they’re timed to your age and personal risk factors. At Medex Diagnostic and Treatment Center in Queens, NY, our primary care doctors help patients stay on track with evidence-based screening schedules for cervical cancer (Pap/HPV testing), breast cancer (mammograms), and colorectal cancer (colonoscopy and other options).

Why does timing matter? Because most early-stage cancers don’t cause symptoms. Screening aims to find precancerous changes (like cervical cell abnormalities or colon polyps) or catch cancer early, when treatment tends to be more effective.

A key takeaway from national data: many adults are still behind on screenings. In 2023, an estimated 75.4% of adults were up to date with cervical cancer screening, 80.0% with breast cancer screening, and 67.4% with colorectal cancer screening—and colorectal screening in ages 45–49 was especially low (about 37.1%).

Below is a clear, age-based schedule you can use as a starting point and practical tips to help you book and prepare.

Quick Age-Based Screening Schedule (Average Risk)

Use this as a general schedule. If you have symptoms, a strong family history, genetic risk, prior abnormal results, or a condition that increases cancer risk, you may need a different plan.

Ages 21–29

• Pap test (cervical cytology): every 3 years
• Mammogram: usually not routine unless higher risk (talk with your clinician)
• Colorectal screening: usually starts later unless higher risk

Ages 30–39

• Cervical screening options (choose one):
  • Pap test every 3 years, or
  • High-risk HPV (hrHPV) test every 5 years, or
  • Co-testing (Pap + hrHPV) every 5 years
• Mammogram: may start earlier for higher-risk patients; otherwise plan for age 40
• Colorectal screening: generally begins at 45 for average risk

Ages 40–44

• Mammogram: many patients begin at 40; USPSTF recommends biennial screening mammography starting at age 40 through 74
• Cervical screening: continue based on the 30–65 schedule above
• Colorectal screening: if you’re approaching 45, plan ahead

Ages 45–49

• Colorectal cancer screening: start at 45 for average risk
  • Colonoscopy every 10 years is one common option (others exist—see below)
• Mammogram: every 2 years (USPSTF 40–74 biennial)
• Cervical screening: continue per schedule

Ages 50–65

• Mammogram: every 2 years (40–74 biennial)
• Cervical screening: continue until 65 (unless advised otherwise)
• Colorectal screening: continue regularly (colonoscopy every 10 years or another method)

Ages 66–74

• Mammogram: continue every 2 years through 74
• Cervical screening: many people can stop after 65 if prior screening has been adequate and results are normal (your clinician will confirm)
• Colorectal screening: continue through 75 for most average-risk adults

Ages 75+

• Mammogram: evidence is considered insufficient by USPSTF for routine screening in 75+; decisions become individualized
• Colorectal screening: ages 76–85: selective screening based on health history and preferences

Why These Screenings Matter

It’s normal to feel fine and still have something developing silently. That’s why routine screening is so important.

Cervical cancer (Pap/HPV)

In the U.S., the American Cancer Society estimates about 13,360 new invasive cervical cancer cases and 4,320 deaths in 2025.
The good news: cervical cancer is often preventable when precancerous changes are found and treated early, which is the purpose of Pap and HPV screening.

Breast cancer (mammograms)

Breast cancer remains a major women’s health issue. CDC data show 279,731 new breast cancers reported among females in 2022, and 42,213 deaths among females in 2023.
Research evidence supports that screening mammography reduces breast cancer–specific mortality, particularly in certain age groups studied in trials.

Colorectal cancer (colonoscopy and other tests)

Colorectal cancer is still one of the leading causes of cancer death. The American Cancer Society estimates about 52,900 deaths from colorectal cancer in 2025.
Screening helps because it can identify cancers earlier—and in the case of colonoscopy, it can also help find and remove polyps before they become cancer.

Cervical Cancer Screening: Pap Test and HPV Testing by Age

Ages 21–29: Pap test every 3 years

For most average-risk patients, the USPSTF recommends cervical cytology (Pap test) every 3 years from 21 to 29.

Helpful reminders

• You generally don’t need Pap testing before 21.
• HPV is common; screening is about preventing cancer, not “judging” exposures.

Ages 30–65: choose one recommended screening strategy

USPSTF-supported options include:

• Pap test alone every 3 years, or
• Primary hrHPV test every 5 years, or
• Co-testing (Pap + hrHPV) every 5 years

ACOG similarly outlines these options for ages 30–65.

Newer direction to know about (HPV self-collection): A USPSTF draft recommendation (Dec 2024) explicitly includes clinician- or patient-collected hrHPV primary screening for ages 30–65.

65+: when screening may stop

Many patients can stop cervical screening after 65 if they’ve had adequate prior screening and are not otherwise high risk. Your clinician should confirm you meet criteria.

You may need a different schedule if you have:

• Prior abnormal Pap/HPV results
• History of cervical cancer or precancer
• HIV or immune suppression
• DES exposure (rare, but important)

Breast Cancer Screening: Mammograms by Age

USPSTF (Final 2024): start at 40, every 2 years through 74

The USPSTF recommends biennial screening mammography for women ages 40 to 74.
This update is important because it simplifies the decision for women in their 40s.

What “biennial” means: every other year.

What about dense breasts, family history, or genetic risk?

USPSTF notes ongoing need for research for some situations (like dense breasts and older ages).
If you have higher risk (strong family history, known mutation like BRCA1/2, prior chest radiation, etc.), your clinician may recommend earlier or more frequent screening and/or additional imaging.

What the evidence says (in plain English):

• Large trials and long-term studies support that screening mammography can reduce deaths from breast cancer.
• Screening can also have downsides (false positives, extra imaging, biopsies, and possible overdiagnosis), which is why shared decision-making matters, especially outside core guideline ages.

Colorectal Cancer Screening: Colonoscopy and Other Options by Age

Start at 45 for average risk

The USPSTF recommends screening for colorectal cancer starting at 45 through 75 for most average-risk adults.
Ages 76–85: screening is selective based on overall health and prior screening history.

Colonoscopy schedule (one common approach)

• Colonoscopy every 10 years is a widely used strategy for average-risk adults.

Other screening choices (not everyone needs colonoscopy first)

USPSTF lists multiple acceptable strategies (stool-based and visual exams).
Examples include:

• FIT (fecal immunochemical test) annually
• Stool DNA-FIT at an interval recommended by your clinician
• CT colonography at guideline intervals
• Flexible sigmoidoscopy (less common today in many settings)

Important: A positive stool test typically requires follow-up colonoscopy.

Why this matters, especially at 45–49

In national data, only ~37% of adults ages 45–49 were up-to-date with colorectal screening in 2023—far below older age groups.
If you’re 45+, getting your first screening on the calendar is a major preventive milestone.

“What If I’m Higher Risk?” (When to Screen Earlier or More Often)

You may need earlier or more frequent screening if you have:

• A first-degree relative (parent, sibling, child) with breast, colorectal, or cervical cancer
• A known hereditary cancer syndrome or strong family history
• Personal history of polyps, inflammatory bowel disease, or prior abnormal biopsy
• Symptoms such as rectal bleeding, unexplained weight loss, new bowel habit changes, post-menopausal bleeding, or a breast lump

Rule of thumb: Screening is for people without symptoms; symptoms deserve a prompt medical evaluation, regardless of age.

Practical Prep Tips (So You Actually Follow Through)

Pap/HPV appointment tips

• Consider scheduling when you’re not on your period (not required, but often easier).
• Bring a list of prior Pap/HPV results if you have them.
• Ask whether you’re due for Pap, HPV, or co-testing based on your history.

Mammogram tips

• Avoid deodorant/antiperspirant on the day of the exam if your imaging center advises it (some products can show on images).
• Wear a two-piece outfit for easier changing.
• If you’ve had imaging elsewhere, ask about transferring prior images for comparison.

Colonoscopy prep tips

• Prep is the hardest part—but it’s also what makes the test accurate.
• Follow the bowel-prep instructions exactly.
• Plan a ride home if sedation is used.

Screening FAQ (Queens, NY)

1) Can I do HPV testing instead of a Pap test?

For many average-risk patients ages 30–65, primary hrHPV testing every 5 years is one recommended option.

2) What’s the biggest change in mammogram guidance recently?

USPSTF issued a final 2024 recommendation: every 2 years starting at 40 through 74.

3) Why does colorectal screening start at 45 now?

USPSTF recommends starting at 45 because of shifting risk patterns and evidence reviewed in its 2021 recommendation.

4) If my stool test is normal, do I still need a colonoscopy?

Not necessarily—your plan depends on which screening strategy you choose and your risk level. But if a stool-based test is positive, colonoscopy is typically the next step.

5) I’m busy—what screening should I prioritize first?

From a population-health perspective, colorectal screening rates lag behind breast and cervical screening nationally.
Practically: prioritize whatever you are overdue for, and start with the test you’re most likely to complete.

How Medex in Queens Can Help You Stay On Schedule

If you’re unsure what you need, a primary care visit can quickly clarify:

• Which screening you’re due for based on age + history
• Which test options fit your preferences and timeline
• What follow-up means if a result is abnormal

Next step: Schedule a preventive visit and ask for a “screening status review” (Pap/HPV, mammogram, colorectal screening). If you’re in Queens (Forest Hills, Rego Park, Jackson Heights, Flushing, Elmhurst, and surrounding neighborhoods), Medex Diagnostic and Treatment Center is a convenient place to start your prevention plan.

Frequently Asked Questions

1) At what age should I start getting a Pap test?
Most people at average risk should start cervical cancer screening at age 21 with a Pap test every 3 years. From ages 30–65, screening may be done with Pap testing, HPV testing, or both—depending on your clinician’s recommendation and your history.

2) What’s the difference between a Pap test and an HPV test?
A Pap test checks cervical cells for abnormal changes. An HPV test checks for high-risk HPV types that can cause cervical cancer. In some cases, both tests are done together (“co-testing”).

3) When should I start getting mammograms?
Many guidelines recommend routine screening mammograms starting at age 40 for average-risk women, typically every 2 years through age 74. If you have higher risk (family history, genetic risk, prior chest radiation), you may need to start earlier or use additional imaging.

4) How often do I need a mammogram?
For average-risk patients, screening is commonly every 2 years starting at age 40. Your schedule may vary depending on personal risk, breast density, and prior imaging findings.

5) When should I start colorectal cancer screening (colonoscopy)?
Most average-risk adults should start colorectal cancer screening at age 45. Colonoscopy is one option, but there are also stool-based tests and imaging-based options—your provider can help you choose.

6) How often do you need a colonoscopy?
For average-risk adults with normal results, colonoscopy is commonly repeated every 10 years. If polyps are found or you have higher risk, you may need it more often.

7) Are there alternatives to colonoscopy?
Yes. Common alternatives include FIT (annual stool test) and stool DNA tests at recommended intervals. If any non-colonoscopy screening test is positive, a colonoscopy is usually needed to complete the evaluation.

8) Can I stop Pap tests after age 65?
Many patients can stop cervical cancer screening after 65 if they have had adequate prior screening with normal results and are not high risk. Your clinician will confirm if it’s safe to stop based on your records.

9) Can I stop colorectal cancer screening after age 75?
For ages 76–85, screening is often individualized based on overall health, prior screening, and preferences. After that, most people do not continue routine screening unless specifically recommended by a clinician.

10) What if I have symptoms like rectal bleeding, a new breast lump, or abnormal bleeding?
Screening is for people without symptoms. If you have concerning symptoms, you should schedule a medical evaluation as soon as possible—your provider may recommend diagnostic testing even if you’re younger than screening age.

Medical Disclaimer

This article is for educational purposes and does not replace individualized medical advice. Screening recommendations vary based on your medical history, family history, and symptoms—please discuss your personalized schedule with a licensed clinician.