Cancer Screening: What You Need and When

A practical guide to Australia’s national screening programs and when symptoms need investigation instead

Cancer screening can find certain cancers — or changes that may lead to cancer — before symptoms appear.

But more testing is not always better.

A useful screening program needs reliable evidence that testing people without symptoms produces more benefit than harm. Screening can save lives, but it can also produce false alarms, unnecessary procedures and the diagnosis of cancers that may never have caused illness.

Australia currently has four national cancer screening programs: bowel, breast, cervical and lung cancer screening. The right tests for you depend on your age, sex, organs, smoking history, family history and previous results.

Screening is different from investigating symptoms

Screening is offered to people who feel well and have no signs suggesting that cancer is already present.

A diagnostic test is used when there is a symptom, examination finding or abnormal screening result that needs investigation. A screening test cannot diagnose cancer by itself.

Do not wait for your next screening invitation if you develop symptoms such as:

• An unexplained lump
• Blood in your bowel motions or urine
• Persistent abnormal bleeding
• Unexplained weight loss
• A changing skin lesion
• A persistent cough or coughing up blood
• New difficulty swallowing
• Ongoing pain or a symptom that is worsening

Most symptoms are not caused by cancer, but persistent or concerning changes deserve assessment.

Bowel cancer screening

Australia’s National Bowel Cancer Screening Program uses an immunochemical faecal occult blood test, usually called an iFOBT.

The test looks for tiny amounts of blood in bowel motions that cannot be seen. A positive result does not mean you definitely have cancer, but it usually needs further investigation — commonly a colonoscopy.

Who is eligible?
People aged 45–74 can access a free bowel screening kit every two years.

• People aged 45–49 can request their first kit online, by calling the National Cancer Screening Register or through a participating healthcare provider.
• People aged 50–74 are generally mailed a free kit every two years.
• Anyone aged 45–74 can ask their doctor about obtaining a kit.

The test involves collecting two small samples from two separate bowel motions and returning them to the laboratory.

When the standard program may not be enough
Speak with your GP before relying on the screening kit if you:

Have bowel symptoms

Have had previous polyps or bowel cancer

Have inflammatory bowel disease

Have a significant family history

Have already been advised to undergo colonoscopy surveillance

People at increased familial risk may need earlier or different screening.

Breast cancer screening

A mammogram is a low-dose X-ray of the breasts. It can identify changes that are too small to feel.

BreastScreen Australia offers free mammograms every two years to women and other eligible people aged 40 and over.

Routine invitation letters are mainly sent to people aged 50–74, because the evidence of benefit is strongest in that age group. People aged 40–49 and over 74 can still book free screening, but they are not routinely invited.

When to speak with your GP first
You may need an individual plan if you have:

• A strong family history of breast or ovarian cancer
• A known gene variant such as BRCA1 or BRCA2
• Previous breast cancer
• Previous chest radiotherapy at a young age
• A breast lump, nipple discharge or skin change

A screening mammogram is not the right pathway for a new breast symptom. Symptoms require diagnostic assessment, which may include examination, diagnostic mammography, ultrasound or biopsy.

Cervical screening

The Cervical Screening Test looks for human papillomavirus, or HPV, which causes almost all cervical cancers.

Most people aged 25–74 who have a cervix and have ever had sexual contact should have a Cervical Screening Test every five years.

This applies whether you:

• Have had the HPV vaccine
• Have sex with men, women or people of another gender
• Are no longer sexually active
• Have been through menopause

You may no longer need screening if your cervix was removed during a total hysterectomy, but this depends on why the surgery occurred and your previous results. Check with your GP.

Self-collection is available
Eligible people can choose either:

• A self-collected vaginal swab
• A clinician-collected cervical sample using a speculum

Both are safe and accurate ways to collect a sample for HPV testing. Depending on the result and clinical history, a clinician-collected sample or further assessment may still be required.

Do not wait for screening if you have symptoms
Seek assessment for:

• Bleeding after sex
• Bleeding between periods
• Bleeding after menopause
• Persistent unusual vaginal discharge
• Unexplained pelvic pain

Cervical screening is preventive testing. Symptoms need diagnostic assessment.

Lung cancer screening

Australia’s National Lung Cancer Screening Program began on 1 July 2025.

It uses a low-dose CT scan, not a chest X-ray, to look for early lung cancer in people at high risk who do not have symptoms.

Who is eligible?
You may be eligible if you are 50–70 years old and:

• Have no symptoms suggesting lung cancer
• Currently smoke, or stopped smoking within the past 10 years
• Have a cigarette-smoking history of at least 30 pack-years

One pack-year is roughly equivalent to smoking 20 cigarettes a day for one year. For example:

• One pack a day for 30 years equals 30 pack-years
• Two packs a day for 15 years also equals 30 pack-years

Your healthcare provider can help estimate your smoking history and assess whether screening is suitable.

Eligible participants usually have another low-dose CT scan after two years unless the result requires a different follow-up plan.

You do not need to stop smoking before participating, although stopping remains one of the most effective ways to reduce future cancer and cardiovascular risk.

A persistent cough, coughing up blood, unexplained breathlessness or weight loss requires diagnostic assessment rather than routine screening.

What about prostate cancer screening?

Australia does not have a national population screening program for prostate cancer.

The prostate-specific antigen, or PSA, blood test may detect some clinically important cancers. However, it can also identify slow-growing cancers that would never have caused harm, leading to further tests and treatments with possible urinary and sexual adverse effects.

Men without symptoms who are considering PSA testing should make an informed decision with their GP after discussing potential benefits and harms.

Current Australian guidance generally recommends that men who choose regular PSA testing consider:

• Testing every two years from age 50–69 if they do not have a family history
• Earlier testing, often from age 40–45, when family history substantially increases risk

A PSA result does not diagnose cancer. Infection, benign prostate enlargement, recent ejaculation and other factors can raise the level.

Urinary symptoms should be assessed, but they are commonly caused by non-cancerous prostate enlargement rather than cancer.

What about skin cancer screening?

Australia does not currently have a national population-based skin cancer screening program.

There is no single recommended schedule that suits everyone. Your need for professional skin checks depends on factors including:

• Previous melanoma or skin cancer
• Many or unusual moles
• Fair skin or a tendency to burn
• Significant sun exposure
• Family history of melanoma
• Immunosuppression
• A changing or concerning lesion

Become familiar with your skin and seek assessment for a lesion that is new, changing, bleeding, persistently itchy or not healing.

A GP may recommend regular planned examinations if your risk is high.

What about other cancers?

There are no routine population screening programs for ovarian, pancreatic or testicular cancer in people at average risk without symptoms.

Blood tests and scans marketed as broad “cancer checks” can produce false reassurance or false-positive findings. Testing may be appropriate for selected people with strong family histories, inherited cancer syndromes or concerning symptoms, but this requires an individual plan.

Testicular cancer is often first noticed as a lump, swelling, heaviness or change in one testicle. Report changes rather than waiting for a routine screening appointment.

Family history can change the plan

The national programs are designed mainly for people at average population risk.

Tell your GP if close relatives have had:

• Bowel cancer
• Breast or ovarian cancer
• Prostate cancer
• Pancreatic cancer
• Melanoma
• Several different cancers
• Cancer at an unusually young age

The pattern matters. One relative diagnosed at 82 may have different implications from several close relatives diagnosed in their 40s.

Your GP may recommend earlier testing, more frequent surveillance or referral to a familial cancer clinic.

Screening has possible harms

Screening can be valuable, but no test is perfect.

Possible harms include:

• False-positive results
• Anxiety while awaiting further tests
• False-negative results
• Unnecessary biopsies or procedures
• Complications from investigations
• Overdiagnosis of a cancer that would never have caused illness
• Overtreatment

This is why national screening programs use specific age ranges and testing intervals rather than recommending every possible test every year.

Keep your details up to date

The National Cancer Screening Register manages invitations, reminders and screening histories for the bowel, cervical and lung programs.

You can update your information, check participation details or request help by contacting the register on 1800 627 701.

Your GP can also help check whether you are due or overdue.

Start with one change

Choose one useful action:

• Complete the bowel kit sitting unopened at home
• Check when your last Cervical Screening Test was
• Book a BreastScreen mammogram
• Ask whether you meet the lung-screening criteria
• Discuss PSA testing with your GP
• Record your family cancer history
• Arrange assessment of a new symptom or changing skin lesion

Screening only works when the test is actually completed and abnormal results are followed up.

The bottom line

Cancer screening is for people without symptoms and is designed to detect disease early — or prevent it developing.

Australia has national screening programs for:

• Bowel cancer from age 45 to 74
• Breast cancer, with routine invitations from age 50 to 74 and free access from age 40
• Cervical cancer every five years from age 25 to 74 for eligible people with a cervix
• Lung cancer for selected people aged 50 to 70 with a substantial smoking history

Prostate and skin cancer require individual risk-based discussions rather than one national schedule.

Know which programs apply to you, keep your contact details current and never wait for routine screening when you have a concerning symptom.