Clinic Compass

Educational information only — not medical advice. Clinic Compass is not a doctor and does not provide diagnosis or treatment. Always confirm with a licensed clinician. In an emergency, call 911 or your local emergency number.

Guide · United States

Screenings & scans to ask for

These are the tests that catch cancer and vascular problems before they cause symptoms. Missing them is where not having a family doctor hurts most. Use the country switch below to tailor guidance.

Evidence strength
Guideline-recommended
A guideline body gives this a graded recommendation for someone with your profile.
Shared decision — worth discussing
Guidelines recommend deciding this together with a clinician rather than testing everyone.
Commonly ordered — evidence is mixed
No guideline body currently recommends this as routine screening for people without symptoms. It's still frequently ordered, and some clinicians and patients want it as a baseline — but the evidence that it improves outcomes is weak or absent. If you're paying cash, this is the group to think hardest about.

Colorectal cancer screening

Start at 45. Colonoscopy every 10 years, or FIT stool test yearly.
Cancer screening

Colorectal cancer is one of the most preventable cancers when caught early.

Ask for it like this

"I'm due for colorectal screening. Can you order a FIT test, or refer me for a colonoscopy?"

If they hesitate

"If a colonoscopy isn't available to me, can I at least get a FIT/FOBT kit today? That's the screening entry point in most programs."

Cost & coverage — United States
Usually no cost to you

Colorectal screening from age 45 is a graded preventive service — including the follow-up colonoscopy after a positive stool test, which must be covered as screening.

Set your state for a more specific note.

Expect your results: A FIT/FOBT kit is usually back in 1–2 weeks after you return it. A colonoscopy result is discussed the same day, but biopsy results take 1–2 weeks.

Sources

Early colonoscopy (family history)

Start 10 years before your relative's diagnosis, or age 40
Cancer screening

Family history significantly raises your risk and lowers the recommended start age.

Ask for it like this

"I have a first-degree relative with colon cancer — I need a referral for a colonoscopy."

If they hesitate

"I have a first-degree relative with colorectal cancer, which usually moves screening earlier than 45. Can we act on that family history?"

Sources

Cervical cancer screening (Pap / HPV)

21–29: Pap every 3 years. 30–65: HPV test every 5 years.
Cancer screening

HPV-driven cervical cancer is almost fully preventable with screening. Testosterone can cause atrophic changes that need a note on the requisition so the lab interprets the sample correctly.

Ask for it like this

"I have a cervix and I'd like a Pap and HPV test. If a speculum exam is uncomfortable, can we discuss self-collected HPV swabs?"

If they hesitate

"If a speculum exam is a barrier for me, is HPV self-collection available here or through the provincial/state program?"

Cost & coverage — United States
Usually no cost to you

Cervical cancer screening is a graded preventive service with no cost-sharing on ACA plans.

Set your state for a more specific note.

Expect your results: Usually 2–4 weeks. Ask when you should expect to hear back and who to call if you don't.

Sources

Mammogram / chest imaging

Every 1–2 years from 40–74
Cancer screening

Screening reduces breast cancer deaths from age 40. Trans women on estrogen for 5+ years have similar risk to cis women and are screened the same way.

Ask for it like this

"I'd like a mammogram referral. (Trans women on estrogen 5+ years: same recommendation.)"

If they hesitate

"Can you give me the requisition or the self-referral number for the screening program? I don't need a full visit for it."

Cost & coverage — United States
Usually no cost to you

Screening mammography is a graded preventive service. Diagnostic follow-up imaging is not always free — ask before you go.

Set your state for a more specific note.

Expect your results: Usually 1–2 weeks for a screening result; a callback for extra images can come within days.

Sources

Chest wall check after top surgery

Annual clinical chest exam; imaging only for symptoms
Cancer screening

Top surgery removes most, but not all, breast tissue. Cancer risk is low but not zero.

Ask for it like this

"I've had top surgery — can you do a clinical chest wall exam and show me how to check the residual tissue myself?"

If they hesitate

"Residual chest tissue still carries some risk after top surgery. What screening is appropriate for me specifically?"

Sources

Early mammogram (family history)

Start 10 years before the relative's diagnosis; discuss MRI too
Cancer screening

BRCA and other genetic risks change the screening timeline substantially, regardless of gender identity.

Ask for it like this

"I have family history of breast/ovarian cancer — can I get a genetic-risk referral and early imaging?"

If they hesitate

"My family history moves my screening start age earlier than the general population — can we go by that?"

Sources

Low-dose CT (lung cancer)

Yearly from 50–80 if 20+ pack-year smoking history
Cancer screening

Catches lung cancer at a curable stage in high-risk smokers.

Ask for it like this

"I have a smoking history — I'd like a low-dose CT lung cancer screen."

If they hesitate

"I meet the smoking pack-year criteria. Is there a lung screening program in this province/state I can be referred to?"

Cost & coverage — United States
Usually no cost to you

Annual low-dose CT is a graded preventive service if you meet the age and pack-year criteria.

Set your state for a more specific note.

Sources

Skin check

Self-check monthly; clinician check when a spot changes — no routine interval
Cancer screening

A clinician looking at moles or spots that have changed. USPSTF found insufficient evidence for routine whole-body skin exams in adults without symptoms — but asking about a specific lesion that has changed is different, and worth doing.

Ask for it like this

"Can you look at any moles that have changed? I don't have a dermatologist."

If they hesitate

"I'm not asking for a full-body exam today — can you just look at this one spot and tell me if it needs dermatology?"

Sources

Anal cancer screening

Discuss yearly if HIV+, MSM, or history of receptive anal sex
Cancer screening

HPV-related anal cancer risk is higher for people living with HIV and for people who have receptive anal sex. Under-screened in most primary care.

Ask for it like this

"Given my history, should I have an anal Pap or high-resolution anoscopy?"

If they hesitate

"If this clinic doesn't do it, can you refer me to a sexual-health or HIV clinic that does anal cytology?"

Sources

Blood pressure check

At every visit, at least yearly from 18
Heart & vascular

Hypertension is silent and the #1 preventable cause of stroke.

Ask for it like this

"Please check my blood pressure and tell me the numbers so I can track it."

If they hesitate

"Can I get one reading today and a note of the number so I can track it? A single high reading isn't a diagnosis, but I need a starting point."

Expect your results: Same visit — ask for the actual numbers before you leave.

Sources

Baseline ECG

Once around 40, or earlier with symptoms/family history
Heart & vascular

A baseline makes it far easier to spot changes later.

Ask for it like this

"Can I get a baseline ECG to keep on file?"

If they hesitate

"I'm reporting palpitations / chest discomfort. If an ECG isn't warranted, can you write down what you're ruling it out on?"

Expect your results: Same visit for the tracing; a formal read by a cardiologist can take 1–2 weeks.

Sources

Clot-risk conversation (on estrogen)

At start of therapy and yearly
Heart & vascular

Oral estrogen raises venous clot risk more than transdermal. Worth knowing before surgery or long flights.

Ask for it like this

"I'm on estrogen — can we review my clot risk, especially if I smoke, travel long-haul, or need surgery?"

If they hesitate

"Estrogen therapy raises clot risk. What symptoms should send me to emergency, and should anything be monitored?"

Sources

Atrial fibrillation check

Ask about pulse checks / ECG from 65, or sooner with palpitations
Heart & vascular

AFib is a leading cause of stroke and often has no symptoms.

Ask for it like this

"I'd like to be checked for atrial fibrillation — pulse check or ECG."

If they hesitate

"A pulse check takes ten seconds — can you feel for an irregular rhythm while you're here?"

Sources

Abdominal aortic aneurysm ultrasound

One-time ultrasound between 65 and 75 if you've ever smoked
Heart & vascular

A ruptured aneurysm is usually fatal; the one-time scan prevents that. Recommended based on smoking history — some guidelines extend to anyone assigned male at birth who smoked.

Ask for it like this

"I'd like the one-time AAA ultrasound."

If they hesitate

"I'm a man over 65 who has smoked — that's the one-time ultrasound criterion. Can I get the requisition?"

Cost & coverage — United States
Usually no cost to you

One-time ultrasound is a graded preventive service for men 65–75 who have ever smoked.

Set your state for a more specific note.

Sources

BRCA founder-mutation counselling

Once — a shared-decision genetic counselling visit
Cancer screening

About 1 in 40 Ashkenazi Jewish people carries a BRCA1/BRCA2 founder mutation — roughly 10× the baseline rate — sharply raising breast, ovarian, prostate, and pancreatic cancer risk. USPSTF and Canadian guidelines recommend counselling even without a strong family history.

Ask for it like this

"I have Ashkenazi Jewish ancestry. Can I get a referral to genetic counselling to discuss the BRCA1/BRCA2 founder-mutation panel?"

If they hesitate

"I'm asking for a genetics referral, not the test itself — founder mutations in my ancestry group are a recognized referral criterion."

Sources

Earlier PSA discussion (Black ancestry)

Shared-decision conversation starting at 40–45
Cancer screening

Prostate cancer is diagnosed roughly twice as often — and at younger ages — in Black men. Both the American Urological Association and Prostate Cancer Canada recommend starting the shared-decision conversation about PSA at 40–45 for men with African ancestry.

Ask for it like this

"I have African ancestry and a prostate. Can we talk about starting PSA screening earlier than the general 50-year threshold?"

If they hesitate

"My ancestry group has higher prostate cancer incidence and earlier onset — that's why I'm asking to start the conversation earlier."

Sources

Earlier heart-disease risk assessment (South Asian ancestry)

Every 4–6 years starting at 30 (vs 40 baseline)
Heart & vascular

People of South Asian ancestry develop coronary disease 5–10 years earlier and at lower BMIs than the general population. Both major guidelines list it as a risk-enhancer that lowers the threshold for statins and lifestyle intervention.

Ask for it like this

"I have South Asian ancestry, which the ACC/AHA and Canadian Cardiovascular Society flag as a risk enhancer. Can we run a lipid panel and calculate my 10-year CVD risk now, not at 40?"

If they hesitate

"My ancestry group carries higher cardiometabolic risk at lower BMI thresholds — can we screen on that basis?"

Sources

This is not medical advice. Clinic Compass is an educational tool to help you prepare for a walk-in visit. It does not create a doctor–patient relationship, does not diagnose or treat any condition, and is not a substitute for the judgement of a licensed healthcare professional who knows your history. Never delay, avoid, or change medical care because of something you read here. In an emergency, call 911 or your local emergency number.

Your information stays private. Anything you enter — profiles, dates of birth, anatomy, risk factors, completed tests, symptoms, and prep notes — is stored on your own device and, if you sign in, in your private account. It is never shared, sold, or shown to other users, advertisers, or clinicians. Only you can see the data in your account, and you can delete a profile or sign out to wipe local data at any time.