My great-aunt Lucy—God bless her—was adamantly anti–Pap smear. “Dem doctors will steal ya ovaries for scientific experiments! You’ll be barren!” she’d say.  After her renegade daughter got pregnant shortly after getting her Pap smear, Aunt Lucy amended her warning to: “Dem doctors will plant sperm in ya for scientific experiments!” Indeed, we black folks can be a superstitious bunch, but centuries of insensitivity and mistreatment on the part of the medical establishment often fuel our fears. While myths like Aunt Lucy’s may serve as good humor for family folklore, they aren’t the least bit funny when they spook us out of doctor visits. Here’s the 4-1-1 for breast, cervical, colon, lung and prostate cancers; heart disease; and HIV—diagnostic tests that are widely feared but shouldn’t be ignored.

Breast Cancer: Film Screen Mammogram
What is it?
A technician examines your breasts for lumps and thickness by compressing each breast between two plates, allowing them to be X-rayed from different angles. Irregularities that can’t be detected through self-examination can be seen on a mammogram. “They squash your breasts like a spatula mashing meat,” says my mother—exaggerating only slightly. To combat pain, Marisa Weis, MD, founder and president of recommends taking Tylenol beforehand.

Who should get one?
Every woman over 40 should get one at least every   other year, according to the National Cancer Institute. If your family has a high incidence of breast cancer, start testing earlier. Weis suggests having more than one radiologist read your mammography film. “Ask for the results while you’re still there.”

What’s new?
Studies show that digital mammograms, which use the same breast-squishing technique but transfer the image onto a computer screen, are 15% more accurate in detecting breast cancer in women under 50. They are 11% more accurate among those with dense breasts. It may be a good choice for black women, who are less likely to develop breast cancer, but may get an aggressive version.

Breast Cancer:  Breast Biopsy     
What is it?
When a mammogram detects lumps, the doctor needs to determine whether they’re malignant or benign. Using local anesthesia, portions of the lump are removed and tested—or the entire lump can be extracted.

How long does it take?

One to 3 days. Fortunately, 80% of women receive good news.

Cervical Cancer: Pap Smear
What is it?
The most successful of all the cancer-prevention exams, the Pap smear screens for cervical cancer by looking for abnormal cells in the cervix and upper vagina. The doctor swabs cells from the cervix and sends samples to a lab, where they’re screened for the human papilloma virus (HPV), “an asymptomatic, very common virus that’s passed sexually,” says gynecologic oncologist Carolyn Muller, MD. HPV causes almost all cervical cancers. “Just about every woman who’s ever had intercourse will be exposed to it.” Reduce your risk by using condoms.

When should you get one?  
You should get your first Pap smear within a year after having sex for the first time or once a year starting at 18.  

What if the result is abnormal?
An abnormal Pap smear doesn’t mean you have cervical cancer—healthy immune systems usually eliminate HPV with time. But such a result can indicate a higher cancer risk, and additional exams should be performed. Subsequent screenings almost always stop cancer before it starts.

What’s new?
In clinical trials, two vaccines have successfully prevented infection from HPV type 16, which causes more than 50% of cervical cancers. Since most women have already been exposed to HPV, with FDA approval, vaccine promotion campaigns will especially target adolescent girls.

Colon Cancer: Fecal Occult Blood Test
What is it?
A stool sample is checked for blood, a possible sign of colon cancer.

When should you get it?
Yearly starting at age 50—getting one every other year is not as effective. Those with a family history of colon cancer should discuss the frequency of exam with their doctor.

Colon Cancer: Colonoscopy
What is it? This exam checks the entire colon for polyps (the precursors to colon cancer), tumors, ulcers and bleeding. The colonoscopy has replaced flexible sigmoidoscopy, a screening that only checks the bottom fourth of the colon, says gastroenterologist Dayna Early, MD.

What’s involved?
Patients drink a laxative solution to clean the colon the night before the test. The next morning, enemas are given to empty their bowels. An anesthesia called “conscious sedation” relaxes and numbs you without knocking you out. The colon is inflated with air, and a bendable, lighted tube with a tiny camera on the end is inserted through the rectum and passed up the colon. Images are then transmitted onto a TV screen where the doctor can inspect the colon’s lining. Any polyps are removed immediately and tested for cancer.

The downside?
The air may cause temporary gas, bloating and cramping.

How often do you need one?
For those at average risk, once every ten years beginning at age 50. Black folks, who experience higher rates of colon cancer, and those with a family history should talk to their doctor about getting tested earlier. “Polyps don’t cause any symptoms,” Early says. “So if you wait until you feel bad to get tested, you’re more likely to have a cancer that’s not curable.”

Heart Disease: Cardiac Catheterization
What is it? Cardiac catheterization detects problems such as arrhythmias (irregular heartbeat), congenital and valvular heart disease, and coronary heart disease. During coronary angiography, the groin area is numbed and a catheter (an extremely slim, flexible tube) is inserted into a blood vessel and snaked through the vessel to the heart. A picture is taken of the coronary arteries and the heart’s main pumping chamber. Iodine, a contrast dye, is injected through the catheter to provide a better view of possibly blocked or narrowed arteries. If blocked, doctors perform a coronary angioplasty, which is a procedure to restore blood flow through a narrowed or blocked artery.  A balloon is inflated inside the artery, temporarily opening it. “Within seconds, we can decide if there’s a blockage, fix it and prepare for an intervention,” says heart specialist Paul Underwood, MD.

When should you get one?
Only when “there’s a high suspicion that there’s some problem with the heart,” says Dr. Underwood. Insider info: My father, who had the procedure after a heart attack, complained of having to remain flat on his back and completely still for about six hours. “It’s not the most comfortable,” Dr. Underwood admits. Conscious sedation is available, but not required. “Some patients like to watch,” Dr. Underwood says.

What is it?
Both oral fluid and blood tests look for HIV antibodies, which the body produces to fight the virus (sometimes up to three months after infection, which is why negative results before three months may not be accurate). Blood tests are available at clinics, in your doctor’s office or at home using Home Access kits (available in pharmacies). A blood sample is sent to a lab for analysis, and a Western blot, a secondary test of the same blood sample, confirms accuracy. Oral-fluid tests, where the doctor places a swab inside the mouth to collect cells, also look for HIV antibodies.

How long do results take?
With standard antibody tests, from ten days to two weeks.  

What’s faster?
Rapid screening, available at some clinics and doctors offices, allows you to find out your HIV status in 20 minutes. You insert a swab from your mouth into a solution-filled vial that displays two purplish lines for a positive result.

Lung Cancer: CT Lung Scan
What is it?
High-definition computed tomography (CT) lung scans are replacing chest X-rays, which were useful only after people “were coughing up blood or had chest pains,” at which point it’s too late to help them, says internist David A. Fein, MD. CT scans can show tumors as small as 1 to 2 millimeters in diameter. But several visits are usually needed to determine which nodules, if any, are harmful or cancerous. “About 25% to 30% of initial scans will have nodules present,” says Dr. Fein. “About 98% of those turn out to be benign.” If new nodules appear or change shape on subsequent scans “more than 95% are lung cancer,” says Fein.

Who needs one?
High-risk individuals like current smokers, former pack-a-dayers, and those with a family history of the disease.

How often?
Every two years after 40.

Prostate Cancer: Digital Rectal Exam (DRE)
What is it?
The doctor sticks a lubricated finger into the rectum to feel for lumps or hardness of the prostate, which could indicate cancer.

Does it hurt?
Not usually.  The urban legend: “Yes, you’ll still be able to get an erection afterward,” says my Uncle Sheldon. “Someone told me I’d be limp for a week!”

When should you get it?
African-American men are twice as likely to get prostate cancer as white men, and men with a family history should start screening at 40. With early screening, the survival rate is nearly 100%.

Prostate Cancer: Prostate-Specific Antigen Test (PSA)
What is it?
Blood is drawn and checked for higher-than-normal levels of PSA, a chemical produced by the prostate gland, which may be an indication of prostate cancer. This test usually accompanies the DRE.

How long do results take?
One day.

Prostate Cancer: Prostate Biopsy
What is it?
When digital exam or PSA results are abnormal, a biopsy—in which a needle guided by ultrasound extracts about ten tiny slivers from the prostate gland—is required.   

Does it hurt?
It feels like a hard pinch, according to urologist Michael Brawer, MD. Afterward, expect blood in your urine, semen and stool for a couple of days.