Cancer Screening Updates: What You Need to Understand

Every year, tens of thousands of Americans have their lives saved by cancer screenings like colonoscopies, mammograms, and Pap tests. These screenings are often as effective as treatment advances, but at a significantly lower cost – both financially and in terms of human suffering. Early detection is key, as treatments are far more likely to be effective when cancer is caught before symptoms appear. In some cases, like cervical and colon cancer, screening can even prevent the disease by removing abnormal growths before they become cancerous.

The Importance of Routine Screening

The U.S. Preventive Services Task Force recommends routine screening for cervical, breast, colorectal, and lung cancer (for longtime smokers). For these common cancers, the evidence clearly demonstrates that screening saves lives without causing undue harm through false positives or unnecessary treatments. However, screening recommendations can be individualized based on risk factors.

Individualized Screening Plans

“For people with increased risk, screening has become more individualized over the years,” says Rebecca Kehm, a cancer epidemiologist at Columbia’s Mailman School of Public Health. “So people should consult with their physician to come up with a screening plan that is right for them.” Knowing your family history of cancer is a crucial first step, and may also warrant genetic testing to better understand your individual risk.

Recent Changes in Cancer Screening Rules

Recent months have seen several changes to cancer screening rules, driven by new laws and technologies aimed at increasing access to testing.

Expanding Insurance Coverage for Mammograms

An estimated one-third of American adults are behind on their cancer screenings, with affordability being a major barrier. A new law in New York State, effective January 2026, requires insurance companies to cover mammograms – recommended for most women starting around age forty – as well as any necessary follow-up diagnostic tests. This is particularly important as breast cancer is increasingly diagnosed in younger women.

“People who’ve just reached the recommended age for cancer screening tend to have the lowest participation rates,” Kehm explains. “But starting right away is one of the best things you can do to reduce the chances of developing advanced disease.” Women with a family history of breast cancer should discuss early screening options with their doctors in their twenties.

At-Home HPV Testing for Cervical Cancer

Cervical cancer rates in the U.S. Have dramatically decreased since the 1970s due to routine screening with Pap smears and HPV tests. However, about one-quarter of U.S. Women still don’t get screened regularly. To address this, the federal government has updated its guidelines to recommend at-home HPV test kits, allowing women to collect their own samples for laboratory analysis.

Studies show these tests are highly accurate in predicting cancer risk in women aged 30 to 65, and the U.S. Health Resources and Services Administration has approved their use as an alternative to Pap smears. Most U.S. Insurance plans will be required to cover at-home HPV testing and follow-up procedures starting January 1, 2027. Alexandre Buckley De Meritens, a Columbia gynecologist and surgeon, notes that continued improvements in screening rates could eventually lead to the eradication of cervical cancer in the U.S. “Even when this cancer occurs, the difference in prognosis between early-stage and late-stage disease is huge, both in terms of our chances of curing it and for a patient’s quality of life afterwards,” he says.

Improved Access to Lung-Cancer Screening

Lung cancer is the deadliest cancer in the U.S., with nearly 125,000 deaths annually, partly due to low screening rates. Current guidelines recommend annual low-dose CT scans for longtime smokers and former smokers aged 50 to 80, but only one-fifth of eligible individuals comply. 70% of lung cancers are diagnosed at a late, often fatal, stage.

Columbia University Irving Medical Center (CUIMC) has expanded access to lung cancer screening through a program offering low-dose CT scans at clinics throughout the New York City region, with expert analysis at CUIMC. A mobile screening van also provides scans to underserved residents in their neighborhoods. Lung-cancer screening will become more affordable for New Yorkers in 2027, as a new law requires insurers to cover the cost of low-dose CT scans and follow-up tests.

A Word of Caution: Multi-Cancer Tests

Blood tests designed to detect multiple cancers by identifying tumor DNA in the bloodstream are emerging. While promising, Chin Hur, a Columbia physician-scientist, advises caution. Current studies suggest these tests are not yet reliable at detecting cancer early, and may miss more early-stage cancers than they catch.

“One concern is that people will feel a false sense of comfort by receiving a negative result and then skip the other, more reliably screening tests that we should all get,” Hur says. He also points out that follow-up diagnostics for some cancers are not always accurate, potentially leading to unnecessary anxiety and uncertainty. Until multi-cancer blood tests become more reliable, patients should prioritize federally recommended cancer screens.

“I’d say these multi-cancer tests aren’t ready for routine public use just yet,” Hur concludes. “They’re promising, but we still need more evidence showing they actually improve patient outcomes.”