To provide an overview of cancer genomics and cancer screening in older adults with a focus on breast, prostate, and colon cancers. Journal articles, research articles, and web sites. Cancer screening in older populations is often in the context of one or more co-morbid conditions, cancer survivorship, genomic information, and competing health priorities. The field of cancer screening has outgrown the tools available to enable health care providers and older adults to make informed cancer screening decisions. Research is needed to develop clinical screening tools that integrate age, cancer risk, life expectancy, and comorbidity. Health care providers are faced with opportunities and challenges in the prevention and early detection of cancer in older Americans.