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Health screenings for women ages 40 to 64

Health maintenance visit - women - ages 40 to 64; Physical exam - women - ages 40 to 64; Yearly exam - women - ages 40 to 64; Checkup - women - ages 40 to 64; Women's health - ages 40 to 64; Preventive care - women - ages 40 to 64

You should visit your health care provider from time to time, even if you are healthy. The purpose of these visits is to:

  • Screen for medical issues
  • Assess your risk for future medical problems
  • Encourage a healthy lifestyle
  • Update vaccinations
  • Help you get to know your provider in case of an illness

Information

Even if you feel fine, you should still see your provider for regular checkups. These visits can help you avoid problems in the future. For example, the only way to find out if you have high blood pressure is to have it checked regularly. High blood sugar and high cholesterol levels also may not have any symptoms in the early stages. A simple blood test can check for these conditions.

There are specific times when you should see your provider. Below are screening guidelines for women ages 40 to 64.

BLOOD PRESSURE SCREENING

  • Have your blood pressure checked at least once every 2 years. If the top number (systolic number) is from 120 to 139 mm Hg, or the bottom number (diastolic number) is from 80 to 89 mm Hg, you should have it checked every year.
  • If the top number is 130 or greater or the bottom number is 80 or greater, schedule an appointment with your provider to learn how you can reduce your blood pressure.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to have your blood pressure checked more often, but still at least once a year.
  • Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked.

BREAST CANCER SCREENING

  • Women may do a monthly breast self-exam. However, experts do not agree about the benefits of breast self-exams in finding breast cancer or saving lives. Talk to your provider about what is best for you.
  • Your provider may do a clinical breast exam as part of your preventive exam.
  • Women ages 40 to 49 may have a mammogram every 1 to 2 years. However, not all experts agree about the benefits of having a mammogram when women are in their 40s. Talk to your provider about what is best for you.
  • Women ages 50 to 75 should have a mammogram every 1 to 2 years, depending on their risk factors, to check for breast cancer.
  • Women with a mother or sister who had breast cancer at a younger age should consider yearly mammograms. They should begin earlier than the age at which their youngest family member was diagnosed.
  • If you have other risk factors for breast cancer, your provider may recommend a mammogram, breast ultrasound, or MRI scan.

CERVICAL CANCER SCREENING

Cervical cancer screening should start at age 21. After the first test:

  • Women ages 30 through 65 should be screened with either a Pap test every 3 years or the HPV test every 5 years.
  • If you or your sexual partner has other new partners, you should have a Pap test every 3 years.
  • Women ages 65 through 70 can stop having Pap tests as long as they have had 3 normal tests within the past 10 years.
  • Women who have been treated for precancer (cervical dysplasia) should continue to have Pap tests for 20 years after treatment or until age 65, whichever is longer.
  • If you have had your uterus and cervix removed (total hysterectomy), and you have not been diagnosed with cervical cancer, you do not need to have Pap smears.

CHOLESTEROL SCREENING

  • Recommended starting age for cholesterol screening is age 45 for women with no known risk factors for coronary heart disease.
  • Once cholesterol screening has started, your cholesterol should be checked every 5 years.
  • Repeat testing sooner than needed if changes occur in lifestyle (including weight gain and diet).
  • If you have high cholesterol levels, diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.

COLORECTAL CANCER SCREENING

If you are under age 45, talk to your provider about getting screened. You should be screened if you have a strong family history of colon cancer or polyps. Screening may also be considered if you have risk factors such as a history of inflammatory bowel disease or polyps.

If you are age 45 to 75, you should be screened for colorectal cancer. There are several screening tests available:

  • A stool-based fecal occult blood (gFOBT) or fecal immunochemical test (FIT) every year
  • A stool sDNA-FIT test every 1 to 3 years
  • Flexible sigmoidoscopy every 5 years or every 10 years with stool testing with FIT done every year
  • CT colonography (virtual colonoscopy) every 5 years
  • Colonoscopy every 10 years

You may need a colonoscopy more often if you have risk factors for colorectal cancer, such as:

DENTAL EXAM

  • Go to the dentist once or twice every year for an exam and cleaning. Your dentist will evaluate if you have a need for more frequent visits.

DIABETES SCREENING

  • If you are over age 44, you should be screened every 3 years.
  • Having a BMI over 25 means that you are overweight. If you are overweight, you should be screened at age 35. Asian Americans should be screened if their BMI is greater than 23.
  • If your blood pressure is above 130/80 mm Hg, or you have other risk factors for diabetes, your provider may test your blood sugar level for diabetes.

EYE EXAM

  • Have an eye exam every 2 to 4 years ages 40 to 54 and every 1 to 3 years ages 55 to 64. Your provider may recommend more frequent eye exams if you have vision problems or glaucoma risk.
  • Have an eye exam at least every year if you have diabetes.

IMMUNIZATIONS

  • You should get a flu shot every year.
  • Ask your provider if you should get a vaccine to reduce your risk of pneumococcal infection (causes a type of pneumonia).
  • You should have a tetanus-diphtheria and acellular pertussis (Tdap) vaccine once as part of your tetanus-diphtheria vaccines if you did not receive it previously as an adolescent. You should have a tetanus-diphtheria booster every 10 years.
  • You may get a shingles or herpes zoster vaccine at or after age 50.
  • Your provider may recommend other immunizations if you are at high risk for certain conditions.

INFECTIOUS DISEASE SCREENING

  • The US Preventive Services Task Force recommends screening for hepatitis C. Depending on your lifestyle and medical history, you may need to be screened for infections such as syphilis, chlamydia, and HIV, as well as other infections.

LUNG CANCER SCREENING

You should have an annual screening for lung cancer with low-dose computed tomography (LDCT) if all of the following are present:

  • You are age 50 to 80 years AND
  • You have a 20 pack-year smoking history AND
  • You currently smoke or have quit within the past 15 years

OSTEOPOROSIS SCREENING

  • All women over age 50 with fractures should have a bone density test (DEXA scan).
  • If you are under age 65 and have risk factors for osteoporosis, you should be screened.

PHYSICAL EXAM

  • Your blood pressure should be checked at least every year.
  • Your provider may recommend checking your cholesterol every 5 years if you have risk factors for coronary heart disease.
  • Your height, weight, and body mass index (BMI) should be checked at each exam.

During your exam, your provider may ask you about:

  • Depression
  • Diet and exercise
  • Alcohol and tobacco use
  • Safety issues, such as using seat belts and smoke detectors

SKIN EXAM

  • Your provider may check your skin for signs of skin cancer, especially if you're at high risk. People at high risk include those who have had skin cancer before, have close relatives with skin cancer, or have a weakened immune system.

References

Advisory Committee on Immunization Practices. Recommended immunization schedule for adults aged 19 years or older, United States, 2020. www.cdc.gov/vaccines/schedules/index.html. Updated February 3, 2020. Accessed April 18, 2020.

American Academy of Ophthalmology website. Clinical statement: frequency of ocular examinations - 2015. www.aao.org/clinical-statement/frequency-of-ocular-examinations. Updated March 2015. Accessed April 18, 2020.

American College of Obstetricians and Gynecologists (ACOG) website. FAQ178: Mammography and other screening tests for breast problems. www.acog.org/patient-resources/faqs/gynecologic-problems/mammography-and-other-screening-tests-for-breast-problems. Updated September 2017. Accessed April 18, 2020.

American College of Obstetricians and Gynecologists. FAQ163: Cervical cancer. www.acog.org/patient-resources/faqs/gynecologic-problems/cervical-cancer. Updated December 2018. Accessed April 18, 2020.

American College of Obstetricians and Gynecologists. FAQ191: Human papillomavirus vaccination. www.acog.org/patient-resources/faqs/womens-health/hpv-vaccination. Updated June 2017. Accessed April 18, 2020.

American Dental Association website. Your top 9 questions about going to the dentist -- answered. www.mouthhealthy.org/en/dental-care-concerns/questions-about-going-to-the-dentist. Accessed April 18, 2020.

American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes - 2020. Diabetes Care. 2020;43(Suppl 1):S14–S31. PMID: 31862745 pubmed.ncbi.nlm.nih.gov/31862745/.

Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 12.

Brown HL, Warner JJ, Gianos E, et al; American Heart Association and the American College of Obstetricians and Gynecologists. Promoting risk identification and reduction of cardiovascular disease in women through collaboration with obstetricians and gynecologists: a presidential advisory from the American Heart Association and the American College of Obstetricians and Gynecologists. Circulation. 2018;137(24):e843-e852. PMID: 29748185 pubmed.ncbi.nlm.nih.gov/29748185/.

Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in J Am Coll Cardiol. 2019 Jun 25;73(24):3237-3241]. J Am Coll Cardiol. 2019;73(24):e285-e350. PMID: 30423393 pubmed.ncbi.nlm.nih.gov/30423393/.

Mazzone PJ, Silvestri GA, Patel S, et al. Screening for Lung Cancer: CHEST Guideline and Expert Panel report. Chest. 2018;153(4):954-985. PMID: 29374513 pubmed.ncbi.nlm.nih.gov/29374513/.

Meschia JF, Bushnell C, Boden-Albala B; American Heart Association Stroke Council, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838/.

National Cancer Institute website. Breast cancer screening (PDQ) - health professional version. www.cancer.gov/types/breast/hp/breast-screening-pdq. Updated April 29, 2020. Accessed June 9, 2020.

Ridker PM, Libby P, Buring JE. Risk markers and the primary prevention of cardiovascular disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 45.

Siu AL; US Preventive Services Task Force. Screening for breast cancer: US Preventive Services Task Force recommendation statement [published correction appears in Ann Intern Med.2016 Mar 15;164(6):448]. Ann Intern Med. 2016;164(4):279-296. PMID: 26757170 pubmed.ncbi.nlm.nih.gov/26757170/.

Siu AL; US Preventive Services Task Force. Screening for high blood pressure in adults: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163(10):778-786. PMID: 26458123 pubmed.ncbi.nlm.nih.gov/26458123/.

US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for skin cancer: US Preventive Services Task Force recommendation statement. JAMA. 2016;316(4):429-435. PMID: 27458948 pubmed.ncbi.nlm.nih.gov/27458948/.

US Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening for osteoporosis to prevent fractures: US Preventive Services Task Force recommendation statement. JAMA. 2018;319(24):2521-2531. PMID: 29946735 pubmed.ncbi.nlm.nih.gov/29946735/.

US Preventive Services Task Force, Krist AH, Davidson KW, Mangione CM, Barry MJ, et al. Screening for lung cancer. US Preventive Services Task Force recommendation statement. JAMA. 2021;325(10):962-970. PMID: 33687470. pubmed.ncbi.nlm.nih.gov/33687470/.

US Preventive Services Task Force, Davidson KW, Barry MJ, Mangione CM, et al. Screening for prediabetes and type 2 diabetes: US Preventive Services Task Force recommendation statement. JAMA. 2021;326(8):736-743. PMID: 34427594 pubmed.ncbi.nlm.nih.gov/34427594/.

US Preventive Services Task Force website. Final recommendation statement. Cervical cancer screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening. Published August 21, 2018. Accessed April 18, 2020.

US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Published May 18, 2021. Accessed June 29, 2021. 

US Preventive Services Task Force website. Final recommendation statement. Hepatitis C virus infection in adolescents and adults: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/hepatitis-c-screening. Published March 2, 2020. Accessed April 18, 2020.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in J Am Coll Cardiol. 2018 May 15;71(19):2275-2279]. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535 pubmed.ncbi.nlm.nih.gov/29146535/.

  • Mammogram

    Mammogram - illustration

    A mammogram is an x-ray picture of the breasts. It is used to find tumors and to help tell the difference between noncancerous (benign) and cancerous (malignant) disease. One breast at a time is rested on a flat surface that contains the x-ray plate. A device called a compressor is pressed firmly against the breast to help flatten out the breast tissue. Each breast is compressed horizontally,then obliquely and an x-ray is taken of each position.

    Mammogram

    illustration

  • Pap smear

    Pap smear - illustration

    A Pap test is a simple, relatively inexpensive procedure that can easily detect cancerous or precancerous conditions.

    Pap smear

    illustration

  • Effects of age on blood pressure

    Effects of age on blood pressure - illustration

    Blood vessels become less elastic with age. The average blood pressure increases from 120/70 to 150/90 and may persist slightly high even if treated. The blood vessels respond more slowly to a change in body position.

    Effects of age on blood pressure

    illustration

  • Osteoporosis

    Osteoporosis - illustration

    Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue and increased vulnerability to fractures. Osteoporosis may result from disease, dietary or hormonal deficiency or advanced age. Regular exercise and vitamin and mineral supplements can reduce and even reverse loss of bone density.

    Osteoporosis

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  • Fecal occult blood test

    Fecal occult blood test - illustration

    A fecal occult blood test is a noninvasive test that detects the presence of hidden blood in the stool. Blood in the stool that is not visible is often the first, and in many cases the only, warning sign that a person has colorectal disease, including colon cancer.

    Fecal occult blood test

    illustration

  • Squamous cell cancer

    Squamous cell cancer - illustration

    Squamous cell cancer involves cancerous changes to the cells of the middle portion of the epidermal skin layer. It is a malignant tumor, and is more aggressive than basal cell cancer, but still may be relatively slow-growing. It is more likely than basal cell cancer to spread (metastasize) to other locations, including internal organs. Treatment usually involves surgical removal of the tumor along with some surrounding tissue.

    Squamous cell cancer

    illustration

    • Mammogram

      Mammogram - illustration

      A mammogram is an x-ray picture of the breasts. It is used to find tumors and to help tell the difference between noncancerous (benign) and cancerous (malignant) disease. One breast at a time is rested on a flat surface that contains the x-ray plate. A device called a compressor is pressed firmly against the breast to help flatten out the breast tissue. Each breast is compressed horizontally,then obliquely and an x-ray is taken of each position.

      Mammogram

      illustration

    • Pap smear

      Pap smear - illustration

      A Pap test is a simple, relatively inexpensive procedure that can easily detect cancerous or precancerous conditions.

      Pap smear

      illustration

    • Effects of age on blood pressure

      Effects of age on blood pressure - illustration

      Blood vessels become less elastic with age. The average blood pressure increases from 120/70 to 150/90 and may persist slightly high even if treated. The blood vessels respond more slowly to a change in body position.

      Effects of age on blood pressure

      illustration

    • Osteoporosis

      Osteoporosis - illustration

      Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue and increased vulnerability to fractures. Osteoporosis may result from disease, dietary or hormonal deficiency or advanced age. Regular exercise and vitamin and mineral supplements can reduce and even reverse loss of bone density.

      Osteoporosis

      illustration

    • Fecal occult blood test

      Fecal occult blood test - illustration

      A fecal occult blood test is a noninvasive test that detects the presence of hidden blood in the stool. Blood in the stool that is not visible is often the first, and in many cases the only, warning sign that a person has colorectal disease, including colon cancer.

      Fecal occult blood test

      illustration

    • Squamous cell cancer

      Squamous cell cancer - illustration

      Squamous cell cancer involves cancerous changes to the cells of the middle portion of the epidermal skin layer. It is a malignant tumor, and is more aggressive than basal cell cancer, but still may be relatively slow-growing. It is more likely than basal cell cancer to spread (metastasize) to other locations, including internal organs. Treatment usually involves surgical removal of the tumor along with some surrounding tissue.

      Squamous cell cancer

      illustration


     

    Review Date: 4/19/2020

    Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 09/03/2021.

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