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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

Whether you’re having a baby, working toward a healthier lifestyle or managing a chronic condition, you’ll find an expert health care partner at CHI Franciscan. Our experienced women’s health professionals offer superior care at our clinics, hospitals and women’s care centers around the Puget Sound region.

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 or receive specific health screenings. The US Preventive Services Task Force publishes a list of recommended screenings. Below are screening guidelines for women ages 40 to 64.

BLOOD PRESSURE SCREENING

Have your blood pressure checked at least once every year. Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked.

Ask your doctor if you need your blood pressure checked more often if:

  • You have diabetes, heart disease, kidney problems, or are overweight or have certain other health conditions
  • You have a first-degree relative with high blood pressure
  • You are Black
  • Your blood pressure top number is from 120 to 129 mm Hg, or the bottom number is from 70 to 79 mm Hg

If the top number is 130 mm Hg or greater or the bottom number is 80 mm Hg or greater, this is considered stage 1 hypertension. Schedule an appointment with your provider to learn how you can reduce your blood pressure.

BREAST CANCER SCREENING

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.

Screening mammogram is recommended for:

  • Women ages 40 to 49 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 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 screening 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 MRI scan for screening.

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 or both tests every 5 years (called “cotesting”).
  • 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

Cholesterol screening should begin at:

  • Age 45 for women with no known risk factors for coronary heart disease
  • Age 40 to 45 for women with known risk factors for coronary heart disease

Repeat cholesterol screening should take place:

  • Every 5 years for women with normal cholesterol levels
  • More often if changes occur in lifestyle (including weight gain and diet)
  • More often if you have diabetes, heart disease, kidney problems, or certain other conditions

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

All adults who do not have risk factors for diabetes should be screened starting at age 35 and repeated every 3 years.

You should be tested more often If you have other risk factors for diabetes, such as:

  • You a first-degree relative with diabetes
  • You are overweight or have obesity, high blood pressure, prediabetes, or a history of heart disease
  • If you are overweight and have other risk factors such as high blood pressure and are planning to become pregnant

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 that includes an examination of your retina (back of your eye) at least every year if you have diabetes.

IMMUNIZATIONS

Commonly needed vaccines include:

  • Flu shot: get one every year.
  • Tetanus-diphtheria and acellular pertussis (Tdap) vaccine: have as one of your tetanus-diphtheria vaccines if you did not receive it as an adolescent.
  • Tetanus-diphtheria: have a booster (or Tdap) every 10 years.
  • Varicella vaccine: receive 2 doses if you never had chickenpox or the varicella vaccine and were born in 1980 or after.
  • Hepatitis B vaccine: receive 2, 3, or 4 doses, depending on your exact circumstances, if you did not receive these as a child or adolescent, until age 59.
  • Shingles (herpes zoster) vaccine: at or after age 50.

Ask your provider if you should receive other immunizations if you have certain health problems that increase your risk for some diseases such as pneumonia.

INFECTIOUS DISEASE SCREENING

Screening for hepatitis C:

  • All adults ages 18 to 79 should get a one-time test for hepatitis C.
  • Pregnant people should be screened at every pregnancy.

Screening for human immunodeficiency virus (HIV): all people ages 15 to 65 should get a one-time test.

Depending on your lifestyle and medical history, you may need to be screened for infections such as syphilis, chlamydia, and 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

If you are under age 65 and at increased risk of osteoporosis you should be screened with a bone density test (DEXA scan).

Risk factors can include:

  • Long-term steroid use
  • Low body weight
  • Smoking
  • Heavy alcohol use
  • Having a fracture after age 50
  • A family history of hip fracture or osteoporosis

PHYSICAL EXAM

All adults should visit their provider from time to time, even if they are healthy. The purpose of these visits is to:

  • Screen for diseases
  • Assess risk of future medical problems
  • Encourage a healthy lifestyle
  • Update vaccinations
  • Maintain a relationship with a provider in case of an illness

Your height, weight, and body mass index (BMI) should be checked at each exam.

During your exam, your provider may ask you about:

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

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, 2022. www.cdc.gov/vaccines/schedules/hcp/imz/adult.html. Updated February 17, 2022. Accessed August 9, 2022.

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 August 9, 2022.

American Cancer Society website. Breast cancer early detection and diagnosis: American Cancer Society recommendations for the early detection of breast cancer. www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html. Updated January 14, 2022. Accessed August 9, 2022.

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 November 2020. Accessed August 9, 2022.

American College of Obstetricians and Gynecologists. FAQ163: Cervical cancer. www.acog.org/patient-resources/faqs/gynecologic-problems/cervical-cancer. Updated April 2021. Accessed August 9, 2022.

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 August 9, 2022.

American Diabetes Association Professional Practice Committee. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022 Jan 1;45(Suppl 1):S17-S38. PMID: 34964875 pubmed.ncbi.nlm.nih.gov/34964875/.

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/.

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/.

Mora S, Libby P, Ridker PM. Primary prevention of cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 25.

National Cancer Institute website. Breast cancer screening (PDQ) - health professional version. www.cancer.gov/types/breast/hp/breast-screening-pdq. Updated February 10, 2022. Accessed August 9, 2022.

US Preventive Services Task Force website. A and B recommendations. www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Breast cancer: Medication use to reduce risk. www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-medications-for-risk-reduction. Updated September 3, 2019. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Breast cancer: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening. Updated January 11, 2016. Accessed August 9, 2022.

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 August 9, 2022.

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 August 9, 2022.

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 August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Human immunodeficiency virus (HIV) infection: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening. Published June 11, 2019. Accessed August 9, 2022.

US Preventive Services Task Force website. Hypertension in adults: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening. Published April 27, 2021. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement: Lung cancer: Screening. Updated March 9, 2021. www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Osteoporosis to prevent fractures: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening. Published June 26, 2018. Accessed August 9, 2022.

US Preventive Services Task Force website. Prediabetes and type 2 diabetes: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes. Published August 24, 2021. Accessed August 9, 2022.

US Preventive Services Task Force website. Skin cancer: Screening. www.uspreventiveservicestaskforce.org/uspstf/draft-update-summary/skin-cancer-screening-1. Updated March 19, 2021. Accessed August 9, 2022.

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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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 - 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: 4/30/2022

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.

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