Screening and checks: an MCCQE quick reference

Quick reference for MCCQE, about 3 minutes to read. Canadian practice, checked against current guidelines as of November 2026.

Written to help you answer exam questions. Before treating a patient, check the current guideline and local policy. Medical disclaimer

Screening programs are run by the provinces and territories, so ages and tests can differ. These are the patterns the exam expects.

Cancer screening

Colorectal: FIT every 2 years from 50 to 74. A positive FIT needs colonoscopy, not a repeat FIT. A first-degree relative diagnosed under 60: colonoscopy from 40, or 10 years before the youngest diagnosis, every 5 years.
Breast: mammography every 2 years from 50 to 74. Many provinces accept self-referral from 40 (for example Ontario since October 2024). High risk (BRCA, chest radiation before 30): yearly MRI and mammogram from 30.
Cervical: HPV testing every 5 years from 25 is replacing the Pap test every 3 years. HPV 16 or 18 goes to colposcopy. Screen whatever the person's vaccination status or sexual orientation.
Lung: low-dose CT for people at high risk who smoke or have smoked, about 55 to 74, in provincial programs (permanent in British Columbia and Ontario). Always offer help to quit.
Prostate: no routine PSA screening; decide together with the man, explaining benefits and harms in absolute numbers.
Not screened in average risk: ovarian cancer (no CA-125 or ultrasound), thyroid cancer, whole-body imaging.

Blood pressure: at appropriate visits.
Lipids: from 40 in men and women, earlier with risk factors such as diabetes, smoking or family history. Lp(a) once in a lifetime.
Diabetes: risk assessment (CANRISK), then A1c or fasting glucose every 3 years from 40, earlier and more often with risk factors.
Abdominal aortic aneurysm: one ultrasound for men 65 to 80.
Osteoporosis: bone density for everyone at 70, from 50 with risk factors such as a fragility fracture or long-term steroids.

Chlamydia and gonorrhea: yearly for sexually active people under 25, and by risk.
HIV and syphilis: offer with every STI screen.
Hepatitis C: test people with risk factors; some provinces also support one-time testing of adults born 1945 to 1975.
Latent TB: test people at risk (newcomers from high-incidence countries, contacts, some First Nations and Inuit communities), then a chest X-ray before treating.
Newcomers and refugees: vaccines, latent TB, hepatitis B and C, HIV and strongyloides, as the risk applies.

First visit: blood group and antibodies, CBC, rubella, syphilis, HIV and hepatitis B, and urine culture.
Syphilis: at the first visit; many provinces repeat it at 28 to 32 weeks and at birth.
Gestational diabetes: a 50 g glucose challenge at 24 to 28 weeks (the preferred Canadian approach).
Group B strep: swab at 35 to 37 weeks.
Postpartum: screen for depression (EPDS); after gestational diabetes, test again 6 weeks to 6 months after birth.

Newborns: blood spot screening at 24 to 48 hours, hearing, pulse oximetry for heart disease, and a bilirubin check before discharge.
Hips: ultrasound at about 6 weeks after a breech birth or an abnormal exam.
Development: surveillance at every visit (Rourke Baby Record to age 5, Greig Health Record from 6 to 17), with a formal autism tool when there are concerns.

Stop cancer screening when life expectancy is under about 10 years.
Healthy adults do not need a routine annual physical with blood work, ECG or chest X-ray.
Judge a screening program by fewer deaths in trials, not by longer survival after diagnosis (lead-time bias).