Cancer Services - Participant Eligibility

When should I be screened for breast cancer?

• People should start getting screened for breast cancer at age 40 even if they feel healthy. Screening is important because it can find cancer early when it is easier to treat. Some people may need to start screening earlier if they have a strong family history of breast cancer or other risk factors. Your health care provider can help you decide when you should start being screened and how often you should be screened. For more information on breast cancer screening services and recommendations, visit the CDC breast cancer website. 

What is a clinical breast exam? 

• A clinical breast exam (CBE) is a physical examination of your breasts performed by a trained health care provider, who visually inspects and manually feels the breasts, underarms, and nearby lymph nodes to check for lumps, skin changes, or other abnormalities.

What is a mammogram?

• A mammogram is an x-ray picture of the breast. Health care providers use a mammogram to look for early signs of breast cancer, often before symptoms appear. Some people find a mammogram uncomfortable, but it only takes a few moments to complete.

What is a breast magnetic resonance imaging (MRI)?

• A breast MRI uses magnets, radio waves and a computer to take and create detailed pictures of the breast. Breast MRI is used along with mammograms to screen women who are at high risk for getting breast cancer (such as women with BRCA gene mutations or strong family history of breast cancer). Breast MRI is also used to clarify results from a mammogram or ultrasound that are suspicious or inconclusive.

What is a breast ultrasound?

• A breast ultrasound is an imaging test that uses high-frequency sound waves (not radiation) to create detailed pictures (sonograms) of areas inside the breast. A breast ultrasound is used to help clarify mammograms results or to help investigate mammograms showing abnormal results, such as a breast lump. It may also be used together with a breast mammogram, to screen women that have dense breast tissue. A breast ultrasound may also be used to help guide breast biopsies. 

What is a breast biopsy?

• A breast biopsy is a medical procedure where a small sample of breast tissue or fluid is removed and then examined under a microscope. A breast biopsy may be recommended by a doctor when breast imaging results (such as results from a breast mammogram, a breast ultrasound or a breast MRI), reveals a suspicious mass (lump) or other unusual internal breast changes.

When should I be screened for cervical cancer?

• People should start getting screened for cervical cancer at age 21 even if they feel healthy. Screening is important because it can find cancer early when it is easier to treat. Your health care provider can help you choose the screening test that is right for you and tell you how often you should be screened. For more information on cervical cancer screening services and recommendations, go to the CDC cervical cancer website

What is a Pap test or Pap smear?

• The Pap test (also called a Pap smear or cervical cytology) collects cervical cells so they can be checked for changes caused by the human papillomavirus virus (HPV) that may—if left untreated—turn into cervical cancer. The Pap test can find precancers and cervical cancer. Precancers are cervical changes that might become cancer if not treated. The Pap test usually is done at the same time as a pelvic exam. During a pelvic exam, a health care provider checks the reproductive organs.

What is HPV?

• HPV stands for human papillomavirus virus. HPV is a common virus that can affect different parts of your body. There are many different forms of HPV. Some types of HPV are called "high risk" because they can progress to cancer. HPV can cause certain types of cancer, including cervical cancer. You can reduce your risk for HPV if you get vaccinated against HPV and get screened and tested regularly.

What is an HPV test?

• Nearly all cervical cancers are caused by long-lasting infection with some high-risk types of human papillomavirus (HPV). Health care providers can test for the high-risk HPV types by looking for pieces of their DNA in cervical cells. This is known as an HPV test. The HPV test is most often used to screen for cervical cancer and precancers (cervical changes that might become cancer if not treated). Sometimes an HPV test is done with a Pap test; this is called a co-test.

What is a colposcopy?

• A colposcopy is a medical procedure that allows a close examination of the surface of the cervix using high-powered microscope. This procedure is used to look for signs of disease and may be recommended by a doctor if results from a Pap test or an HPV test show some concerns or irregularities.

What is a cold knife cone procedure? 

• A cold knife cone procedure, also known as cold knife conization or cone biopsy, is a medical procedure where a cone-shaped section of cervical tissue is removed using a scalpel. A cold knife cone may be recommended by a doctor if results from a Pap test or an HPV test show some concerns or irregularities.

What is a punch biopsy?

• A punch biopsy is a medical procedure that may be recommended by your doctor when a Pap test or colposcopy results detect abnormal cells in your cervix. The procedure uses a tiny circular instrument to remove a small piece of tissue from the cervix, which is then examined under a microscope. This procedure is used to determine whether the abnormal cells detected, are precancerous or cancerous.

What is a loop electrosurgical excision procedure?

• A loop electrosurgical excision procedure (LEEP) is a medical intervention that may be recommended by your doctor when procedures such as Pap tests, HPV testing, colposcopy, or punch biopsies detect abnormal cells in your cervix.  The procedure uses a thin, electrically heated wire loop to remove a layer of cervical tissue. The removed tissue is then analyzed further to confirm diagnosis.

When should I be screened for colorectal cancer?

• People should start getting screened for colorectal cancer at age 45, even if they feel healthy. Screening is important because it can find cancer early when it is easier to treat. Some people may need to start screening earlier if they have a strong family history of colorectal cancer or other risk factors. Your health care provider can help you choose the screening test that is right for you and tell you how often you should be screened. For more information on colorectal cancer screening, go to https://www.cdc.gov/colorectal-cancer/screening/index.html

What is a fecal immunochemical test or FIT kit?

• A FIT kit is a simple, non‑painful test you can do at home to check for signs of colon cancer. It looks for small amounts of blood in your stool or poop. You just follow the instructions and collect a tiny stool sample using tools in the kit. 

What is a colonoscopy? 

• A colonoscopy is a test that lets a doctor look inside your large intestine to check for problems like cancer or pre‑cancerous growths. During the test, a long, flexible tube with a tiny camera is gently placed into the rectum so the doctor can see the inside of the colon. You are given medicine to help you relax and many people sleep through the procedure. A colonoscopy helps doctors find and remove any unusual growths early, when treatment works best.

What if I am at high risk for colorectal cancer, can I still be eligible for the Iowa HHS Colorectal Cancer Screening Program?

• The program covers those at average risk or increased risk. Average risk means a person's personal chance of developing colorectal cancer is similar to that of the general population. Individuals at increased risk include those with a family history of CRC or specific hereditary syndromes. These individuals should have screening more frequently and may need to start earlier than average.

The program cannot cover those who are at high risk of developing colorectal cancer by having one or more of the following conditions: 1. having a genetic diagnosis of familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (HNPCC), 2. a clinical diagnosis or suspicion of FAP or HNPCC, or 3. a history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease). If you have one or more of these conditions, you are not eligible for the program

How do I know if I qualify for lung cancer screening services through the Iowa HHS Lung Cancer Screening Program based on where I live?

• At this time, residents of counties that are considered rural and urban may or may not be eligible based on home address. Visit the Health Resources and Services Administration (HRSA) website to enter your home address to check eligibility. 

  Residents of Polk, Black Hawk and Scott counties are not eligible.  

I meet the qualifications for lung cancer screening, but why should I get screened?

• One benefit of lung cancer screening is that it may find lung cancer early, before a person has symptoms and before the cancer has spread elsewhere in the body. Lung cancer that is found early is more likely to be treated successfully. If lung cancer is caught early, the likelihood of surviving five years or more improves significantly.

What is a low-dose CT scan and does it hurt?

• A computed tomography or CT scan is a low-dose x-ray that takes multiple pictures of a person. It does not hurt. The person lies on a table that slides in and out of the machine. Often, the person does not need to change their clothes if there is no metal on their chest. It is quick, painless, and usually takes a few minutes.

Do I need to quit smoking to be screened for lung cancer?

• No, you do not need to quit smoking. To qualify for a lung cancer screening, you must either be currently smoking tobacco or have quit within the last 15 years. If you are interested in quitting smoking, Quitline Iowa can help, but you can be screened for lung cancer if you are still currently smoking.

I would like to quit smoking. What resources are there for me?

• If you need help to stop using tobacco or nicotine, Quitline Iowa is a free program that has helped many people quit tobacco. The professional quit coaches and online community provide support and connections to resources like nicotine quit medications. For more information on Quitline Iowa and to connect with a personal coach: 
  • Visit quitlineiowa.org 
  • Call 1-800-QUIT-NOW (784-8669) 
  • Text START to 300500
  • For Iowans ages 13 to 17 years old, check out My Life My Quit

I don’t have insurance and need to be screened for another type of cancer (not breast, cervical, colorectal or lung). Does Iowa HHS have a free screening program for uninsured adults for other types of cancer?

• Iowa HHS does not have a free screening program for uninsured or underinsured adults for other types of cancer. 

How do I know which cancer screenings are right for me?

• Iowa HHS encourages you to talk with your health care provider about what cancer screenings are recommended for you. Tell your health care provider about your family health history and your personal health history. The American Cancer Society has information about which screening guidelines by age.

How do I know if I am at risk for cancer? 

• You can talk to your health care provider about your medical history and family medical history to discuss your personal risk for cancer. One free tool you can use to find out what steps you could take to reduce your risk of developing some types of cancer is the American Cancer Society Cancer Risk Assessment: ACS CancerRisk360. The assessment takes just a few minutes. When you’re finished answering the questions, you’ll get personalized tips to help you on your journey – not a numerical risk score or level – but clear, practical steps you can take to help reduce your cancer risk.

What are ways I can reduce my risk for cancer?

• A cancer risk factor is something that raises the chance of getting cancer. Cancer risk factors include exposure to chemicals or other substances, as well as certain behaviors. They include things people cannot control, like age and family history. The older we are, the more likely we are to develop cancer. But some cancer risk factors can be controlled or modified. About 40% of cancers are attributable to modifiable risk factors. Having a cancer risk factor does not mean someone will get cancer. Often it is a combination of different genetic, lifestyle and environmental risk factors that change the function of cells and result in a cancer forming. These are some steps that can be taken to reduce the risk of developing cancer:
  • Do not smoke or use any form of tobacco. 
  • Make your home smoke-free.
  • Decrease excess body weight.
  • Be physically active.
  • Eat a healthy diet.
  • Limit alcohol consumption.
  • Avoid too much sun and practice sun safety.
  • Reduce indoor and outdoor air pollution and test your home for radon. 
  • Vaccinate against hepatitis B and HPV.
  • Limit exposure to environmental contaminants that can cause cancer. For example, if you drink water from a well, have your water tested for contaminants like nitrates and arsenic.