Health screenings for 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
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
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 a year. If the top number (systolic number) is between 120 and 139 or the bottom number (diastolic number) is between 80 and 89 mm Hg or higher, have it checked every year.
- 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.
- Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked.
- Begin cholesterol screening between the ages of 40 to 45.
- Once cholesterol screening has started, your cholesterol 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.
- If you are over age 44, you should be screened every 3 years.
- If you are overweight, ask your provider if you should be screened at a younger age. Asian Americans should be screened if their BMI is greater than 23.
- If your blood pressure is above 140/80 mm Hg, or you have other risk factors for diabetes, your provider may test your blood sugar level for diabetes.
COLORECTAL CANCER SCREENING
If you are under age 50, talk to your health care 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 between ages 50 to 75, you should be screened for colorectal cancer. There are several screening tests available:
- A fecal occult blood (stool-based) test done every year
- A fecal immunochemical test (FIT) every year
- A stool DNA test every 3 years
- Flexible sigmoidoscopy every 5 years
- Double contrast barium enema every 5 years
- 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:
- Ulcerative colitis
- A personal or family history of colorectal cancer
- A history of growths in the colon called adenomatous polyps
- 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.
- 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.
- 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 (Tap) 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 after age 50.
- Your provider may recommend other immunizations if you are at high risk for certain conditions.
- 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:
- Diet and exercise
- Alcohol and tobacco use
- Safety issues, such as using seat belts and smoke detectors
- 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 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.
- 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.
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 may be tested every 5 years. HPV is the virus that causes genital warts and several cancers, including 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), and you have not been diagnosed with cervical cancer, you do not need to have Pap smears.
- Women who are sexually active and at high risk should be screened for chlamydia and gonorrhea. Your provider may talk with you about testing for other infections.
- Your provider will ask you about alcohol and tobacco, and may ask you about depression.
- 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.
LUNG CANCER SCREENING
The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 55 to 80 years who:
- Have a 30 pack-year smoking history AND
- Currently smoke or have quit within the past 15 years
American Academy of Ophthalmology website. Policy statement: frequency of ocular examinations - 2015. www.aao.org/clinical-statement/frequency-of-ocular-examinations. Updated March 2015. Accessed April 15, 2019.
American Cancer Society website. Breast cancer early detection and diagnosis. www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection.html. Updated October 9, 2017. Accessed April 15, 2019.
American College of Obstetricians and Gynecologists (ACOG) website. Mammography and other screening tests for breast problems. www.acog.org/Patients/FAQs/Mammography-and-Other-Screening-Tests-for-Breast-Problems. Updated September 2017. Accessed April 15, 2019.
American College of Obstetricians and Gynecologists. Practice bulletin no. 168: cervical cancer screening and prevention. Obstet Gynecol. 2016;128(4):e111-e30. PMID: 27661651 www.ncbi.nlm.nih.gov/pubmed/27661651.
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 15, 2019.
American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes - 2019. Diabetes Care. 2019;42(Suppl 1):S13-S28. PMID: 30559228 www.ncbi.nlm.nih.gov/pubmed/30559228.
Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2016: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 www.ncbi.nlm.nih.gov/pubmed/29748185.
Cosman F, de Beur SJ, LeBoff MS, et al. Clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int. 2014;25(10):2359-2381. PMID: 25182228 www.ncbi.nlm.nih.gov/pubmed/25182228.
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. J Am Coll Cardiol. 2018 Nov 8. pii: S0735-1097(18)39034-X. PMID: 30423393 www.ncbi.nlm.nih.gov/pubmed/30423393.
James PA, Oparil S, Carter BL, 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;311(5):507-520. PMID: 24352797 www.ncbi.nlm.nih.gov/pubmed/24352797.
Kim DK, Hunter P. Advisory Committee on Immunization Practices recommended immunization schedule for adults aged 19 years or older - United States, 2019. MMWR Morb Mortal Wkly Rep. 2019;68(5):115-118. PMID: 30730868 www.ncbi.nlm.nih.gov/pubmed/30730868.
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 www.ncbi.nlm.nih.gov/pubmed/25355838.
Moyer VA; US Preventive Services Task Force. Screening for lung cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330-338. PMID: 24378917 www.ncbi.nlm.nih.gov/pubmed/24378917.
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. Ann Intern Med. 2016;164(4):279-296. PMID: 26757170 www.ncbi.nlm.nih.gov/pubmed/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 www.ncbi.nlm.nih.gov/pubmed/26458123.
Smith RA, Andrews KS, Brooks D, et al. Cancer screening in the United States, 2019: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2019;69(3):184-210. PMID: 30875085 www.ncbi.nlm.nih.gov/pubmed/30875085.
Stone NJ, Robinson JG, Lichtenstein AH, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S1-S45. PMID: 24222016 www.ncbi.nlm.nih.gov/pubmed/24222016.
US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2016;315(23):2564-2575. PMID: 27304597 www.ncbi.nlm.nih.gov/pubmed/27304597.
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 www.ncbi.nlm.nih.gov/pubmed/27458948.
US Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening for cervical cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018;320(7):674-686. PMID: 30140884 www.ncbi.nlm.nih.gov/pubmed/30140884.