Prevention and Screening

You can help prevent cancer by reducing some behaviors and starting others. To reduce cancer risk, experts recommend that you:

• Eat a healthy diet, including fruits and vegetables
• Get regular exercise (at least 150 minutes per week) and stay at a healthy weight
• Practice safe sex
• Receive vaccinations for hepatitis B and HPV, if recommended by your doctor
• See your doctor for regular checkups
• Wear sunscreen when you’re going out in the sun

Some behaviors put you at higher risk for developing certain cancers. Our specialists recommend that you:

•  Avoid chewing tobacco
• Limit the amount of alcohol you drink to no more than one drink per day (women) or two drinks per day (men)
• Reduce your exposure to radiation, second-hand smoke and harmful chemicals
• Stop smoking

Our cancer team recommends regular screenings for certain cancers. We have training and experience in screening techniques that help find cancer early-even if you're not having symptoms. We recommend:

Breast cancer screening

A mammogram is a breast X-ray that looks for tissue changes. Screening mammograms for breast cancer typically begin at age 40 for individuals assigned female at birth. If you notice any changes in your breasts, talk with your doctor right away.

Cervical cancer screening

During a Pap test (Pap smear), the doctor scrapes a small sample of tissue from your cervix. Specialists look at the tissue under a microscope to check for changes that might show cervical cancer.

Screening recommendations are based on your age and health history, so it's important to talk to your primary care provider or OB/Gyn about the best cervical cancer screening option for you. Cervical cancer affects women, especially those who have not been protected by the HPV vaccine.

Generally, we recommend the following cervical screening schedule:

• Under age 21: Screening not recommended.
• If you are age 21-29, you should have a Pap test every three years.
• If you are age 25-65, you have three options* for screening:
  • An HPV test every 5 years
  • Both a Pap test and an HPV test together every 5 years
  • Pap test every 3 years

If you are over 65 and have had regular cervical cancer testing in the past 10 years with normal results, you do not need to continue screening for cervical cancer.

If you have a history of a cervical pre-cancer, you should be tested every 3 years for at least 20 years after diagnosis, even if testing goes beyond age 65.

*Your provider can help you decide which test and preventive vaccine are right for you.

Colon cancer screening

Our experts recommend colon cancer screening beginning at age 45. If you have a family history of colon cancer or have certain risk factors, we may recommend that you begin screening earlier.
We may screen for colon cancer with:

• Colonoscopy: We place a tube with a light and video camera (colonoscope) into your rectum to inspect the colon and rectum for abnormal tissue and polyps. Colonoscopies are recommended every 10 years.
• Stool tests: We examine a sample of your stool (feces) to look for signs of cancer. Stool tests are recommended annually.

We offer different types of tests to screen for colon cancer. Talk with your doctor about which screening is right for you.

Genetic testing

A genetic counselor can perform personalized cancer risk assessments for you. Our experts at Sentara perform genetic testing, sometimes called germline genetic testing, on a blood or salvia sample and look for rare, inherited mutations. After interpreting the results, we work with you and our physicians to advise you on managing your, and possibly your family's, hereditary risk of breast, ovarian, colon cancers and others. Genetic testing results can also help your cancer team make treatment decisions if you're undergoing cancer care. 

Lung cancer screening

Our experts recommend screening for lung cancer for adults ages 50 to 80 years who have a 20 pack/year history of smoking and currently smoke or quit within the last 15 years. We do this screening with a non-invasive imaging test called a low-dose CT scan. Talk with your doctor about whether you qualify for this screening.

Pancreatic cancer Screening

Your doctor might recommend genetic testing if you have a family history of pancreatic cancer. The results could show a gene mutation. You and your genetic counselor might decide on further testing as well.

Prostate cancer screening

Men should engage in shared decision-making with their health care providers and other trusted sources of information to learn about the pros and cons of screening. After the discussion, men who want to be screened should get the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening. The discussion about screening should take place at:

• Age 40 for Black men and those with several first degrees relatives (father, son, or brother) who have been diagnosed with prostate cancer at a young age. This is generally before age 65.
• Age 45 to 50 for those with one first degree family member diagnosed with prostate cancer before age 65.
• Age 50 and older, who are at average risk of developing a prostate cancer, have no family history or personal risk factors, and are expected to live 10 years or more.

Men over aged 70 who have previously undergone prostate screening are encouraged to speak with their provider about continuing prostate screenings. This can be based on age, life expectancy, overall health, family history, and past PSA results. 

Skin cancer screening

If you have light skin or a history of skin cancer in your family, you might have regular skin cancer screenings. A physician performs a visual exam of your skin, checking for marks that are unusual in size, shape or texture.