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Health screening - women - ages 40 - 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 of 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 health care 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 - 64.

BLOOD PRESSURE SCREENING

  • Have your blood pressure checked every 2 years. If the top number (systolic number) is between 120 - 139 or the bottom number (diastolic number) is between 80 - 89 mm Hg or higher, have it checked every year.
  • Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked. Or check your blood pressure using the automated machines at local grocery stores and pharmacies.
  • If the top number is greater than 140, or the bottom number is greater than 90, schedule an appointment with your provider.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to have your blood pressure checked more often.

CHOLESTEROL SCREENING

  • If you are over age 44, you should be checked every 5 years.
  • If you have high cholesterol levels, diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.

DIABETES SCREENING

  • If you are over age 44, you should be screened every 3 years.
  • If your blood pressure is above 135/80 mm Hg, or you have other risk factors for diabetes, your provider may test your blood sugar level for diabetes.

COLON CANCER SCREENING

If you are under age 50, you should be screened only if you have a strong family history of colon cancer or polyps, or have a history of inflammatory bowel disease or polyps.

If you are between ages 50 - 75, you should be screened for colorectal cancer. This may involve:

  • A stool test done every year
  • Flexible sigmoidoscopy every 5 - 10 years, along with a stool guaiac test
  • Colonoscopy every 10 years

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

  • Ulcerative colitis
  • A personal or family history of colorectal cancer
  • A history of large colorectal adenomas

DENTAL EXAM

  • Go to the dentist every year for an exam and cleaning.

EYE EXAM

  • Have an eye exam every 1 - 3 years if you have vision problems or glaucoma risk.

IMMUNIZATIONS

  • You should get a flu shot every year.
  • Ask your provider if you should get a vaccine to reduce your risk of pneumonia.
  • You should have a tetanus-diphtheria and acellular pertussis (TdAP) vaccine once as part of your tetanus-diphtheria vaccines. You should have a tetanus-diphtheria booster every 10 years.
  • You may get a shingles or herpes zoster vaccine once after age 60.

PHYSICAL EXAM

  • You should have a physical exam every 1 - 2 years.
  • Your height, weight, and body mass index (BMI) should be checked at each exam.
  • Routine diagnostic tests are not recommended.

BREAST EXAM

  • 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.
  • You should contact your provider immediately if you notice a change in your breasts, whether or not you do self-exams.
  • Your provider should do a complete breast exam as part of your preventive exam.

MAMMOGRAM

  • Women ages 40 - 49 may have a mammogram every 1 - 2 years. However, not all experts agree about the benefits of having a mammogram in finding breast cancer or saving lives. Talk to your provider about what is best for you.
  • Women ages 50 - 75 should have a mammogram every 1 - 2 years, depending on their risk factors, to check for breast cancer.

OSTEOPOROSIS SCREENING

  • All postmenopausal women 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.

PELVIC EXAM AND PAP SMEAR

  • You should have a Pap smear every 3 years. If you have both a Pap smear and human papilloma virus (HPV) test, you can be tested every 5 years. HPV is the virus that causes genital warts and cervical cancer.
  • Your provider may do pelvic exams more often if you develop problems.
  • If you have had your uterus and cervix removed (total hysterectomy), you do NOT need to have Pap smears.
  • Women who are sexually active and at high risk should be screened for chlamydia infection. This can be done during a pelvic exam.
  • Your provider will ask you questions about alcohol and tobacco, and may ask you about depression.

SKIN EXAM

  • The American Cancer Society recommends a skin exam as part of a periodic exam by your provider, if it is indicated.
  • The U.S. Preventive Services Task Force (USPSTF) does not recommend for or against performing a skin self-exam.

LUNG CANCER SCREENING

The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 55 - 80 years who:

  • Have a 30 pack-year smoking history AND
  • Currently smoke or have quit within the past 15 years

Alternative Names

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

References

American College of Obstetricians and Gynecologists. Committee opinion no. 463: Cervical cancer in adolescents: screening, evaluation, and management. Obstet Gynecol. 2010;116:469-472.

American College of Obstetricians and Gynecologists. Practice bulletin no.122: Breast cancer screening. Obstet Gynecol. 2011;118:372-82.

American College of Obstetricians and Gynecologists. Practice Bulletin No. 99: Management of abnormal cervical cytology and histology. Obstet Gynecol. 2008;112:1419-1444.

American College of Obstetricians and Gynecologists. Practice bulletin no. 131: Screening for cervical cancer. Obstet Gynecol. 2012;120:1222-1238.

American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37 Suppl 1:S14-S80.

Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 14.

Centers for Disease Control and Prevention. Recommended Immunization Schedule for Adults, United States, 2014. Available at http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule.pdf. Accessed July 24, 2014.

Gaziano M, Ridker PM, Libby P. Primary and secondary prevention of coronary heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders; 2012:1010.

Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014 Feb 5;311(5):507-520.

Helfand M, Carson S. Screening for Lipid Disorders in Adults: Selective Update of 2001 US Preventive Services Task Force Review. Rockville, MD: Agency for Healthcare Research and Quality (US); 2008 Jun.

Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women--2011 update: A guideline from the American Heart Association. Circulation. 2011;123(11):1243-1262.

Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes? JAMA. 2014 Feb 5;311(5):474-476.

Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2012;62(3):147-72.

Screening for Breast Cancer. U.S. Preventive Services Task Force. Available at http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm. Accessed July 24, 2014.

Screening for Cervical Cancer. U.S. Preventive Services Task Force. Available at http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm. Accessed July 24, 2014.

Smith RA, Cokkinides V, Brooks D, Saslow D, Brawley OW. Cancer screening in the United States, 2010. A review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin. 2010; 60(2):99-119.

Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz N,  Blum CB, et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. Circulation. 2014 Jun 24;129(25 Suppl 2):S1-S45.

Update Date: 8/8/2014

Updated by: Deborah Greenberg, MD, Associate Professor of Medicine, Division of General Internal Medicine, University of Washington, Seattle, WA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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