Following the loss of Dawson’s Creek actor James Van Der Beek after a battle with colorectal cancer, and news surrounding other recent high-profile diagnoses, conversations about the C-word have felt heartbreakingly close. The unfortunate reality is that cancer is always a little closer than we would like to believe it is — according to the American Cancer Society, approximately 2.1 million new cancer cases are expected to be diagnosed in the U.S. in 2026.
Of course, it’s not healthy to live our lives from a place of fear (and, actually, stress weakens your immune system and encourages inflammation, both of which can support cancer growth), but we all want to feel like we’re doing… something. Being proactive. So, naturally, conversations about early detection are everywhere.
In that spirit, actress and internet personality Christy Carlson Romano, along with her husband, decided to take a precautionary cancer screening test. And as she vulnerably shared in an Instagram video, hers came back positive. She’s now awaiting further imaging to understand better what that means.
With stories like these surfacing so much, it’s natural to wonder: Am I doing everything I should be doing?
The idea of cancer screenings can feel really confusing and overwhelming. That’s to say nothing of the flood of online ads about DIY at-home versions that just seem to muddy the waters even more. I asked experts to help me cut through some of the noise surrounding this very important topic to find out what we really need to know about when to get screened, whether at-home tests are legit, and what insurance typically covers.
Why do screenings matter so much?
“Get screened. Get screened. Get screened,” says Megan C. Turley, M.D., MHS, a colon and rectal surgeon with Texas Oncology. She says that’s the single most important message she always gives to people.
Dr. Turley has seen firsthand the rising rates of early-onset colorectal cancer, especially in women. She says that roughly 50% of the oncology patients she treats are female, and cases in younger adults (particularly women) are increasing.
“We don’t know why it’s rising,” she tells Scary Mommy. “Improved access to screening is our best opportunity for early intervention until we understand the underlying cause.”
And that holds true for all types of cancer: Screening saves lives.
What screenings should you be getting, and when?
I know there’s nothing more frustrating than a non-specific answer, but cancer screening just isn’t a one-size-fits-all scenario. Different cancers have different guidelines, and varying factors may lead your doctor to recommend early screening for you (or not).
“Every screening test has its own indications,” explains James J. Chao, MD, FACS, co-founder and chief medical officer of VedaNu Wellness in San Diego. “Some diseases have screening tests because we know how early detection alters disease outcomes. Cancers of the breast, colon, cervix, and prostate have routine screening because we know that if found at Stage 1 or 2 (early disease), we can offer definitive treatment and improve cure rates. Some screening tests, like skin exams and new multi-cancer screenings, are still having their effectiveness studied.”
Dr. Chao emphasizes that, since no single screening test can diagnose all forms of cancer, “your doctor should order tests on evidence-based screening guidelines,” as “screening is most powerful when a physician considers your family history, ethnicity, age, prior biopsies, and other clinical factors.”
With that being said, here’s a general overview of standard, evidence-based screening recommendations for average-risk adults:
Breast Cancer (Mammogram)
- Typically begins between the ages of 40 and 44
- Done every 1–2 years
- Often detects tumors less than 1 cm before symptoms appear
- Risk assessment tools like the Gail Model and Tyrer-Cuzick Risk Assessment Calculator can help start the conversation with your doctor
Colorectal Cancer (Colonoscopy or Stool-Based Tests)
- Begins at age 45 for average risk
- Colonoscopy every 10 years if normal (other screening options exist, too)
- Earlier screening may be recommended based on family history or symptoms
- At-home blood and/or stool tests like the gFOBT, Cologuard, and ColoSense should all still be used under the purview of a doctor
Cervical Cancer (Pap Smear/ HPV Test)
- Pap smear begins at age 21
- HPV co-testing typically begins at age 25
- The HPV vaccine is recommended for people ages 9 to 45 to be used as a preventative tool in conjunction with screenings
What about those at-home, multi-cancer blood tests?
When the Hulu limited series The Dropout first came out in 2022, with Amanda Seyfried starring as disgraced Theranos founder Elizabeth Holmes, I remember thinking: Damn, it sucks she was a fraud because it would be incredible to actually have a blood test that could screen for, like, *everything* with a single finger prick.
In recent years, more and more ads have popped up online promising “the next best thing”: blood tests that claim to detect dozens of cancers early. The big hitch? These direct-to-consumer, multi-cancer early detection tests can cost a lot, with prices starting somewhere around $800 to $1,200 and beyond. And since these are typically not ordered by a doctor, they’re usually out-of-pocket expenses.
According to Chao, these kinds of tests should be met with a “proceed with caution” and “if it’s too good to be true, it probably is” kind of mentality. “Direct-to-consumer screening tests are becoming more popular, but just because you can order these tests doesn’t mean you should,” Chao tells us.
He elaborates, “Outside of medical supervision, an abnormal at-home test can be vague and difficult to understand. With no formal appointment or relationship with a doctor, a positive result can create anxiety without giving you clear next steps.”
And as far as accuracy, it can be a mixed bag.
“It depends on the test,” Chao says. “Some multi-cancer screens available by bloodwork advertise a sensitivity of up to 50% for early disease and greater than 80% for late-stage disease. That is a big difference.” Plus, he adds, false-positive rates vary by modality but are often between 5 – 15%, resulting in anything from simple anxiety to an unnecessary biopsy.
Does insurance cover cancer screenings?
You probably don’t need me to tell you that the world of health insurance can be infuriating, even on a good day. While what — and how much — is covered is dependent on your individual insurance plan, generally speaking:
- Guideline-recommended screenings (colonoscopies at 45, mammograms at 40, Pap smears, etc.) are typically covered.
- Genetic testing (like BRCA) may be covered depending on family history.
- Direct-to-consumer multi-cancer blood tests are usually not covered by insurance.
If a screening is strongly recommended by medical organizations and ordered by your physician, insurance is far more likely to cover it.
If a screening comes back positive, what happens next?
OK, breathe and repeat after me: A screening test is not a diagnosis. Think of it more as a starting point. If the result is positive, your next step is to go see your doctor for confirmatory testing. This might include imaging, a biopsy, or a referral to a specialist.
“No test should ever be viewed as a ‘diagnosis,’” says Chao. “Only your doctor can determine what a positive test means for you and your treatment options. Your screening result is simply the first step in a diagnostic process that often involves surgery to treat cancer.”
The Bottom Line
It’s really, really easy to feel overwhelmed and scared when headlines bring cancer closer to home. But experts agree strongly on this point: Early detection saves lives. The most important thing you can do is establish care with a provider you trust. They can help you review your risk factors and keep you on track with evidence-based screening guidelines.
And don’t forget to use your voice! You are your best advocate. If something doesn’t feel right, talk to your doctor about early screening options.
