Screening Anxiety: What Happens During the Test

This page walks through what happens during five common cancer screening tests, with tips to make each one easier.

Whether and when to be screened is worth discussing with your care team. Even if you decide to go ahead, it is normal to feel a wave of nerves first. You might worry it will hurt. You might feel exposed. You might dread what the result could say.

Screening is routine testing done when you feel well. Diagnostic testing looks into a symptom you already have. Knowing which one you are having helps. So does knowing what each exam involves, step by step. Fear of the unknown shrinks once the unknown part is gone.

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Representative Story Disclosure
This is a representative story created from common experiences described by patients and caregivers. It is not the story of one identifiable person, and individual experiences can differ substantially.

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Maya, a 46-year-old high school librarian, put off her first mammogram for two years. She worried the squeezing would be very painful. She also dreaded sitting in a waiting room thinking about results.

After her primary care provider gently explained how modern mammograms work, Maya scheduled her appointment for a Tuesday morning. She told the technologist upfront: "I'm really nervous about pain and results."

The technologist walked her through each step and adjusted the positioning carefully. Three days later, Maya received a letter confirming her results were clear.

Maya reflected:
"Knowing what to expect and telling the technologist I was nervous made a huge difference. The anticipation was much worse than the actual exam."

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Here is what usually happens during five common screening tests. Your clinic may do things differently, so ask them what to expect.

1. Mammogram (Breast Screening)

• What it is: Low-dose X-ray images of breast tissue.
• What happens: Your breast is placed between two plates that are pressed together, and several images are taken from different angles. For some people the compression can be painful.
• Comfort tip: NCI says to try not to schedule a mammogram right before or during your menstrual period, when breasts may be especially tender. Avoid deodorants, antiperspirants, powders, lotions, creams or perfumes around the breasts or under the arms on the day. NCI says an over-the-counter pain medicine taken beforehand may lessen discomfort; ask your care team what is right for you.

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2. Colonoscopy & Stool Tests (Colorectal Screening)

• What it is: Examination of the inner lining of the colon, or at-home stool test kits (FIT/sDNA).
• What happens (Colonoscopy): Before the test you follow a special diet and clean out your colon with clear liquids and laxatives, as your care team instructs. You receive sedation through an IV. A doctor uses a flexible tube with a camera to examine the colon and can remove polyps or take tissue samples.
• Duration: NIDDK says the exam typically lasts under one hour. You will stay at the facility for a while afterward.
• Comfort tip: Follow your care team's prep instructions closely and arrange a ride home, since sedation prevents you from driving. After the test, call your care team or seek medical attention right away for severe abdominal pain, fever, or bleeding that does not stop.

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3. Pap Test & HPV Testing (Cervical Screening)

• What it is: Collecting a small sample of cervical cells to check for human papillomavirus (HPV) or cell changes.
• What happens: During a pelvic exam, a provider uses a speculum to open the vagina and a soft, narrow brush or tiny spatula to collect a small sample of cells from the cervix. The sample can be tested for HPV and for abnormal cell changes. Some people may have the option to collect the sample themselves.
• Comfort tip: Tell your clinician if you are nervous, and ask them to go slowly.

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4. Low-Dose CT Scan (Lung Screening for Eligible Smokers)

• What it is: A chest CT scan using a small amount of radiation. The U.S. Preventive Services Task Force recommends it yearly for adults aged 50 to 80 who have a 20 pack-year smoking history and currently smoke or quit within the past 15 years.
• What happens: You lie on a table and an X-ray machine makes detailed images of your lungs. No needles or contrast dye are required.
• Duration: The CDC says the scan only takes a few minutes and does not hurt.

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5. Skin Exam

• What it is: A visual inspection of your skin by a clinician.
• Important: The U.S. Preventive Services Task Force says there is insufficient evidence to assess whether routine skin exams by a clinician benefit adults without symptoms. If you have a new or changing spot on your skin, see your care team rather than waiting for a routine exam.
• What happens: Your clinician looks at your skin. Ask your clinic what to expect.

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1. Tell Your Technologist: Let the staff know if you feel nervous or sensitive to pain. Technologists are trained to go at your pace.
2. Bring Distractions: Listen to music or a podcast in the waiting room to keep your mind engaged.
3. Plan a Post-Exam Reward: Schedule a pleasant activity — such as coffee with a friend or a quiet walk — immediately following your visit.
4. Remember the Follow-Up: An abnormal result usually means more tests, not a diagnosis. For mammograms, NCI says most people who are called back are not found to have breast cancer.

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Short answers to common questions about screening.

What happens if my screening test shows something unexpected?

Your doctor will contact you to explain the finding and recommend a diagnostic follow-up (such as a diagnostic mammogram). Do not wait to follow up if you are asked to come back.

How often should I get screened?

Screening intervals depend on your age, biological sex, and personal or family risk factors. Ask your primary care provider for your personalized screening schedule.

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• Cancer Screening Overview
• Colonoscopy Step-by-Step
• Mammogram Basics
• Abnormal Pap or HPV Test: What Now?

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• National Cancer Institute — Cancer Screening Overview (PDQ), Patient Version
• U.S. Preventive Services Task Force — Lung Cancer: Screening
• National Cancer Institute — Mammograms
• NIDDK — Colonoscopy
• National Cancer Institute — Cervical Cancer Screening
• CDC — Lung Cancer Screening
• U.S. Preventive Services Task Force — Skin Cancer Screening