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VitalDecades Guides & Explainers

Preventive care and screenings 14 min

At what age can you stop getting colonoscopies? What each guideline says

For adults at average risk, the USPSTF, ACS, the gastroenterologists' Multi-Society Task Force and ACP all end routine colorectal cancer screening at 75. From 76 to 85 the first three make it an individual decision based on health and past screening, while ACP says stop after 75. ACS and the Task Force say no screening after 85. The USPSTF says people never screened are more likely to benefit from a late test.

Preventive care and screenings 14 min

Your mammogram says dense breasts: do you need more imaging?

Not automatically. The FDA's notice tells you only whether your tissue is dense and names no test. The USPSTF calls the evidence on supplemental ultrasound or MRI insufficient, ACOG does not recommend routine extra tests without other risk factors, and ACR recommends MRI for women with dense breasts who want supplemental screening. Your overall breast cancer risk, not density alone, is what decides it.

Preventive care and screenings 11 min

What does a free PSA percentage mean?

Percent free PSA is the share of total PSA that circulates unbound, and a lower share means a higher chance of cancer on biopsy. The familiar 25% cutoff comes from a 1998 trial and one assay's FDA labeling for PSA 4 to 10, and results from different assays are not interchangeable.

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Preventive care and screenings 13 min

My PSA is between 4 and 10: what happens next

The AUA/SUO guideline says a newly elevated PSA, such as a first result of 4 to 10 ng/mL, should be repeated first. If it stays raised, the guideline's pathway runs through a risk assessment and may include an MRI before any biopsy decision, and lets patient and clinician forgo a near-term biopsy when the risk is sufficiently low.

Preventive care and screenings 12 min

Can you get lung cancer screening before 50? What each guideline says

None of the four US rules quoted here starts lung cancer screening before 50: the USPSTF, the American Cancer Society, CHEST's broadest band and Medicare all start at 50. CHEST recommends against screening under 50 unless clinical risk prediction or life-year gained calculators project a high net benefit, and none of the four makes family history a criterion.

Preventive care and screenings 14 min

Is Cologuard as good as a colonoscopy? What the trials and the USPSTF modeling show

As a single test, no: in the trials the FDA reviewed, Cologuard detected 92.3% to 95.3% of the cancers colonoscopy found but only 42.4% to 43.4% of advanced precancerous lesions, and a positive result needs a colonoscopy. Repeated on schedule with full adherence, USPSTF modeling estimates 303 (every 3 years) to 333 (yearly) life-years gained per 1,000 for stool DNA testing, against 337 for colonoscopy every 10 years.

Preventive care and screenings 11 min

When do you stop lung cancer screening after quitting smoking?

The USPSTF and Medicare end lung cancer screening eligibility once you have gone 15 years without smoking. The American Cancer Society removed that rule in 2023, so former smokers with a 20 pack-year history stay eligible from 50 to 80 under ACS. CHEST keeps the limit but allows a calculator-based exception.

Preventive care and screenings 11 min

Should women over 75 still get mammograms? What each guideline says

No major US guideline sets a stop age for mammograms at 75. The USPSTF calls the evidence for women 75 and older insufficient (an I statement, 2024), while ACS, ACOG and ACR tie the decision to health and life expectancy, and Medicare keeps paying for a yearly screen with no upper age.

Preventive care and screenings 9 min

Normal PSA levels by age: what the guidelines actually say

No body publishes a normal PSA by age. The decade-by-decade cutoffs you have seen are in the AUA guideline's background text, citing a 1993 paper, not in any numbered recommendation. Here is what age does decide, with the grades attached.

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Preventive care and screenings 3 min

Vaccines recommended after 50, by decade

From the CDC's adult schedule (2025): every adult gets an annual flu vaccine and a Td/Tdap booster every 10 years. At 50, two doses of the shingles vaccine (Shingrix, 2 to 6 months apart) and pneumococcal vaccination switch on. RSV vaccination is routine at 75 and risk-based from 50 to 74, one dose. COVID-19 dosing follows the current season's notes. Risk conditions move several of these earlier; the schedule is rechecked yearly.