When it comes to preventing cancer, early detection is everything. But with all the noise online—from trendy full-body scans to viral “biohacking” tests—it’s easy to miss the tools that are actually proven to save lives. In this article, we’ll cut through the confusion and focus on the evidence-based cancer screenings that can make a real difference. If you want to know which tests are worth your time (and which aren’t), read on.
Table of Contents
- Why Screening Matters (And Where We Go Wrong)
- The South Korea and UK Cautionary Tales
- The Screenings That Are Proven to Save Lives
- A Word on Full-Body MRI Scans
- Public Health vs. Personal Preference
- References
Why Screening Matters (And Where We Go Wrong)
I feel like I’m just screaming into the void at times.
A few days ago—shared with permission—I had a mid-50s patient diagnosed with stage 4 lung cancer. He has three young kids. This kind of late-stage diagnosis should never have happened.
We have robust cancer screening programs that can detect cancer long before it causes symptoms—when we can annihilate it.
But so many people don’t know the guidelines. And while people are unaware of evidence-based prevention programs, I see the internet obsessed with trendy, expensive full-body MRI scans. We’re focusing on the wrong things.
In this article, we’re going to fix that.
We’ll go through the programs that are proven to save lives—the ones you actually need to prioritize. Then, I’ll give you my honest take on the pros and cons of full-body MRIs. My conclusion will surprise many of you.
The South Korea and UK Cautionary Tales
The American Cancer Society maintains a list of screening recommendations based on the latest evidence, including a recent, important update [1].
These are the screenings proven to save lives. That qualification is critical. Otherwise, we risk repeating public health disasters—like what happened in South Korea.
In South Korea, thyroid cancer diagnoses exploded. In 1999, there were 6.3 cases per 100,000 people. By 2009, it jumped to nearly 48—more than a 7-fold increase [2].
So what happened?
Doctors weren’t detecting more aggressive cancers. Instead, they were just finding more cases that had been there all along, thanks to widespread use of ultrasound funded by a government screening initiative [2].
You’d expect earlier detection to lower death rates. But that’s not what happened. Thyroid cancer mortality stayed the same [2].
Between 2001 and 2012, thyroid surgeries rose from 1,000 to about 11,000 per year. Yet, no change in mortality was observed [3].
Most of these surgeries were unnecessary. Many of the cancers were so slow-growing they’d never cause harm. But surgeries come with risks, and in this case, no benefit.
A similar thing happened in the UK. A massive trial tested screening for ovarian and tubal cancers using blood tests and ultrasounds. The result? No difference in mortality between the screened and unscreened groups. Worse, there were significant numbers of unnecessary surgeries on benign growths [4].
These examples show that more information does not always equal better outcomes. Sometimes, screening can be harmful.
That’s why we need to focus on the few screenings where evidence clearly shows a benefit.
The Screenings That Are Proven to Save Lives
Let’s break it down.
Breast Cancer
Women should have the option to begin annual mammograms at age 40, with annual screening recommended from age 45 to 54. At 55 and older, screening can be every two years [1].
There’s concern online that mammograms might increase cancer risk due to radiation. But the exposure is tiny. A UK analysis projected that regular mammograms save between 150 to 300 lives for every single life lost to radiation exposure [5].
Also, if there's a family history of breast cancer, screening may need to start earlier.
Cervical Cancer
Start screening at age 25, and continue until at least 65. Depending on the test, this should be done every 3 to 5 years [1].
Options include:
- HPV test every 5 years
- Self-collected HPV test every 3 years
- Co-test (HPV + Pap) every 5 years
- Pap test alone every 3 years (if HPV testing isn’t available)
Endometrial Cancer
Here, screening is not for everyone. But at menopause, all women should be informed about the risks and symptoms. Women with a particular medical history may need annual endometrial biopsies [1].
Prostate Cancer
This one surprises many men.
There’s no blanket recommendation. Instead, starting at age 50, talk with your doctor about whether screening is right for you [1].
Why the caution? Because 1 in 5 men die with prostate cancer, not from it. Many cancers grow so slowly they’d never cause harm—just like in the thyroid example.
Biopsies and treatments can cause more harm than good in these cases.
Colorectal Cancer
This one applies to everyone.
Screenings should begin at age 45 and continue to age 75, assuming you’re in good health [1].
Rates are rising globally, especially among younger adults [6].
The good news? You don’t necessarily need a colonoscopy. There are now stool-based tests that are highly sensitive to colorectal cancer signs [1].
Personally, I plan to start my first stool-based screening at age 35. This isn’t official guidance, and I don’t recommend it to patients. But for me, the test is so easy, I’m happy to do it earlier.
Lung Cancer
There’s been a recent change in the guidelines here.
Screening with low-dose CT (LDCT) is recommended for people aged 50 to 80 who:
- Currently smoke or used to smoke
- Have at least a 20 pack-year smoking history [1]
A pack-year = 1 pack/day for 1 year. So 20 pack-years could mean 1 pack/day for 20 years, or 2 packs/day for 10 years.
But this cutoff may soon change.
A recent study found that switching to a 20-year smoking duration (regardless of how many cigarettes per day) could save an additional 30,000 lives over 5 years in the U.S. alone [7].
This new approach is:
- Easier to calculate
- More inclusive
- Likely more effective [8]
So if you have a history of smoking—even if you smoked lightly for a long time—you may still benefit from screening under this proposed model.
A Word on Full-Body MRI Scans
The promise of full-body MRI scans is seductive: Find problems before symptoms start. Catch cancer early. Get peace of mind.
But the American College of Radiology recommends against total body screening in people without symptoms or specific risk factors [9].
Why?
Because:
- There’s no evidence these scans improve outcomes or extend life [9]
- They often find non-specific abnormalities, triggering more tests, procedures, and anxiety [9]
This is how we risk another South Korea-style situation—finding slow-growing cancers that wouldn’t have caused harm, but leading to surgeries and stress without benefits.
Public Health vs. Personal Preference
Here’s the key difference.
For public health, we need hard data. Until full-body MRI screening is proven to save lives, it’s not worth the risk and cost across a whole population.
But for individuals, it’s more nuanced.
Some people are comfortable with uncertainty. I’m one of them. I plan to get a full-body MRI. If it finds something, I’d prefer to monitor it—even if we don’t know what it is.
Others would be overwhelmed by worry. For them, not knowing may actually be better for their mental and physical health.
So while public health guidelines don’t support full-body MRIs, the decision at a personal level can vary—depending on your preferences and tolerance for risk.
References
2. https://www.bmj.com/content/355/bmj.i5745
3. https://www.nejm.org/doi/10.1056/NEJMc1507622
4. https://pubmed.ncbi.nlm.nih.gov/37183782/
6. https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(24)00600-4/fulltext
7. https://jamanetwork.com/journals/jama/article-abstract/2841694
