Most cancer screenings happen at your primary care doctor’s office, and that’s the best place to start. Your doctor can perform several common screenings on-site and refer you to specialized facilities for the rest. But depending on the type of screening you need, your insurance status, and where you live, you have several other options worth knowing about.
Your Primary Care Doctor’s Office
Primary care providers handle many routine cancer screenings directly. Pap smears for cervical cancer, clinical breast exams, and skin checks can all happen during a regular office visit. Your doctor can also order a stool-based test for colorectal cancer that you complete at home. For screenings that require imaging equipment, like mammograms or low-dose CT scans for lung cancer, your doctor writes a referral and sends you to an imaging center or hospital outpatient department.
Starting with your primary care provider has a practical advantage: they know your age, family history, and risk factors, so they can tell you which screenings you actually need and how often. They also coordinate follow-up if anything comes back abnormal.
Imaging Centers and Hospitals
Mammograms, colonoscopies, and lung cancer screenings require specialized equipment that most primary care offices don’t have. You’ll typically go to one of these locations:
- Radiology or imaging centers perform screening mammograms and low-dose CT scans for lung cancer. For lung cancer screening specifically, the facility must meet federal criteria, including using a standardized system for identifying and classifying lung nodules and keeping radiation doses within strict limits.
- Hospital outpatient departments offer the same imaging services and often house gastroenterology suites for colonoscopies.
- Ambulatory surgery centers are another common setting for colonoscopies, which involve sedation and a short recovery period.
The FDA maintains a searchable database of certified mammography facilities at FDA.gov/findmammography. You can search by zip code to find accredited locations near you, including some mobile mammography units that serve rural and underserved areas.
Community Health Clinics
Federally qualified health centers (FQHCs) exist in every state and offer preventive services on a sliding fee scale based on income. These clinics provide Pap smears, HPV testing, clinical breast exams, and referrals for imaging. You can find one through the Health Resources and Services Administration’s locator at findahealthcenter.hrsa.gov.
Planned Parenthood health centers are another accessible option for cervical cancer screening. All of their locations offer both Pap tests and HPV tests. You don’t need a referral, and many locations accept patients without insurance.
Home-Based Screening Kits
Not every cancer screening requires a visit to a medical facility. For colorectal cancer, two FDA-approved stool-based tests can be done at home:
- Fecal immunochemical test (FIT) detects hidden blood in a stool sample you collect yourself. It needs to be repeated every year.
- Stool DNA test (sold as Cologuard) checks for both blood and genetic changes linked to colorectal cancer. It’s repeated every one to three years.
Your doctor can order either test and have a kit mailed to your home. You collect the sample, send it to a lab, and get results without setting foot in a clinic. Keep in mind that a positive result on either test still requires a follow-up colonoscopy to look for and remove any growths. A blood-based screening test for colorectal cancer has also recently gained FDA approval and can be done as a simple blood draw at any provider’s office.
NCI-Designated Cancer Centers
If you’re at higher-than-average risk for cancer due to family history, genetic mutations, or a prior cancer diagnosis, an NCI-Designated Cancer Center offers specialized screening programs. These centers, funded and recognized by the National Cancer Institute, often have high-risk clinics with access to advanced imaging, genetic counseling, and screening protocols tailored to your specific risk profile.
There are NCI-Designated Cancer Centers in most states. You can search for one by state at cancer.gov/research/infrastructure/cancer-centers/find. “Comprehensive Cancer Center” is the highest designation, meaning the facility conducts research across prevention, diagnosis, and treatment. You don’t need to be diagnosed with cancer to use their screening services, though some programs require a referral.
What Insurance Covers
Under the Affordable Care Act, most private insurance plans must cover recommended cancer screenings with no out-of-pocket cost to you. This includes mammograms, colonoscopies, Pap tests, and HPV tests when performed at recommended intervals.
Medicare Part B covers screening mammograms once every 12 months (plus a one-time baseline mammogram for women ages 35 to 39), screening colonoscopies once every 120 months (or every 24 months for high-risk individuals), and annual lung cancer screening for those who qualify. These are covered at no cost as long as you use a participating provider.
One important detail: if a colonoscopy is billed as a screening but a polyp is found and removed during the procedure, some plans may reclassify it as diagnostic and apply cost-sharing. Check with your insurer beforehand so you’re not caught off guard.
Free Screenings If You’re Uninsured
The CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides free or low-cost breast and cervical cancer screenings across all 50 states. You may qualify if you meet these criteria:
- You have no insurance, or your insurance doesn’t cover screening exams
- Your yearly household income is at or below 250% of the federal poverty level
- You are between 40 and 64 for breast cancer screening, or 21 to 64 for cervical cancer screening
Some programs extend eligibility beyond these age ranges. Each state runs its own version of the program, so contact your state’s program directly to confirm what’s available. The CDC maintains a directory of local programs at cdc.gov/breast-cervical-cancer-screening.
Federally qualified health centers also serve uninsured patients and charge based on ability to pay. Many hospitals run periodic free screening events, particularly during awareness months like October for breast cancer. Local health departments can often point you to upcoming events in your area.