Cancer screening guidelines compared

The USPSTF is not the only group that sets screening ages. The American Cancer Society (ACS), the American College of Obstetricians and Gynecologists (ACOG), the American College of Physicians (ACP) and the American Urological Association (AUA) publish their own. Here they are side by side for adults at average risk, each with its date.

Average risk only. Every row is for people without symptoms and without a high-risk family history or genetic finding. If that is not you, see family history: when screening starts earlier, and talk to your doctor.

Side by side

Average-risk cancer screening: USPSTF, ACS, ACOG, ACP and AUA compared
Cancer	USPSTF	American Cancer Society	ACOG	ACP	AUA
Breast	Mammogram every 2 years, 40 to 74; from 75, evidence insufficient (USPSTF, 2024)	Option of yearly at 40 to 44; yearly at 45 to 54; every 1 or 2 years from 55, while in good health with 10+ years to live (ACS, 2026)	Every 1 to 2 years from 40, until at least 75 (ACOG)	40 to 49: discuss, then every 2 years if chosen; 50 to 74: every 2 years; from 75: discuss stopping (ACP, 2026)	Not included
Cervical	21 to 29: Pap every 3 years; 30 to 65: Pap every 3, HPV every 5, or both every 5; stop after 65 with adequate past screening (USPSTF, 2018)	Start at 25: HPV test every 5 years (self-collected every 3, or co-test every 5); can stop at 65 if recent tests were normal (ACS, 2025)	Start at 21: Pap every 3 years to 29; 30 to 65: HPV every 5 or co-test every 5; can stop after 65 if criteria are met (ACOG)	No statement on its active list (ACP guidelines list)	Not included
Colorectal	45 to 75; 76 to 85 case by case (USPSTF, 2021)	45 through 75; 76 to 85 by preference and health; stop after 85 (ACS, 2026)	Not included	Start at 50; consider not screening at 45 to 49; stop after 75; stool test every 2 years, colonoscopy every 10, or sigmoidoscopy every 10 plus a stool test every 2 (ACP, 2023)	Not included
Prostate	55 to 69: individual decision (C); from 70: recommends against (D) (USPSTF, 2018)	Talk with a doctor from 50 (45 or 40 at higher risk) (ACS, 2023)	Not included	No statement on its active list (ACP guidelines list)	PSA screening with shared decision-making is recommended, with longer, tailored intervals based on risk (AUA/SUO, 2023)
Lung	Yearly low-dose CT, 50 to 80, 20 pack-years, smoking now or quit within 15 years (USPSTF, 2021)	Yearly low-dose CT, 50 to 80, 20 pack-years, smoke now or used to smoke (ACS, 2024)	Not included	No statement on its active list (ACP guidelines list)	Not included

"Not included" means we compare each group only on the cancers its own screening guidance covers here: ACOG on breast and cervical, the AUA on prostate. ACP's earlier statements on prostate (2013) and cervical (2015) screening are no longer on its active list. (ACP guidelines list)

Where they differ most

Mammograms: how often, and when to start. The USPSTF, ACOG and the ACP start at 40; the ACS makes 40 to 44 optional and advises yearly mammograms at 45 to 54. The USPSTF and ACP use every 2 years; ACOG allows every 1 to 2 years. (USPSTF, 2024) (ACS, 2026) (ACOG) (ACP, 2026)
Colorectal: 45 or 50. The ACP starts at 50; the USPSTF and ACS at 45. (ACP, 2023) (USPSTF, 2021) (ACS, 2026)
Cervical: 21 or 25, Pap or HPV. The USPSTF final statement and ACOG start at 21 with Pap tests; the ACS starts at 25 with HPV tests. The USPSTF has a 2024 draft update, not final, that makes an HPV test every 5 years the main option from 30 to 65, with the others as alternatives. (USPSTF, 2018) (ACOG) (ACS, 2025) Details: cervical cancer screening.
Prostate: who starts the conversation, and when. The USPSTF frames 55 to 69 as an individual decision (see shared decision-making); the ACS starts the talk at 50; the AUA recommends PSA screening with shared decision-making. (USPSTF, 2018) (ACS, 2023) (AUA/SUO, 2023)
Lung: people who quit long ago. The USPSTF stops at 15 years since quitting; the ACS page lists people who smoke or used to smoke without that limit. (USPSTF, 2021) (ACS, 2024)

This site's screening planner and age pages follow the USPSTF only (Method), because its A and B grades are the ones tied to no-cost coverage under the Affordable Care Act: USPSTF grades explained.

Questions people ask

Why do the USPSTF and the American Cancer Society differ on mammograms?

They weigh the same trade-off differently. The USPSTF recommends a mammogram every 2 years from 40 to 74. The ACS gives women 40 to 44 the option of yearly mammograms, advises yearly mammograms at 45 to 54, and lets women 55 and older choose every 1 or 2 years. ACOG notes that different ways of balancing benefits and harms have led major guidelines to differ on when to start, when to stop and how often. (USPSTF, 2024) (ACS, 2026) (ACOG, 2017)

Should colorectal screening start at 45 or 50?

The USPSTF and the ACS say 45. The ACP says 50, and that clinicians should consider not screening average-risk adults aged 45 to 49. All three are about people without symptoms or a family history. (USPSTF, 2021) (ACS, 2026) (ACP, 2023)

Does cervical screening start at 21 or 25?

The USPSTF and ACOG start at 21 with a Pap test every 3 years until 29. The ACS starts at 25 with an HPV test every 5 years. Ask which approach your clinic uses. (USPSTF, 2018) (ACOG) (ACS, 2025)

Which guideline decides what my insurance covers?

Under the Affordable Care Act, most private plans must cover USPSTF grade A and B services without cost sharing. Other groups' guidelines do not carry that rule. (42 U.S.C. 300gg-13)

Which one should I follow?

Decide with your doctor. For mammograms, ACOG notes that the guidelines differ because they balance benefits and harms differently. Bringing this table to the visit can help. (ACOG, 2017)