Here are the screening tests and immunizations that most women ages 50 to 64 need. Although you and your health care provider may decide that a different schedule is best for you, this plan can guide your discussion.
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Screening
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Who needs it
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How often
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Alcohol misuse
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All adults
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At routine exams
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Blood pressure
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All adults
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Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends the following screening schedules:
Every two years if blood pressure reading < 120/80 mm Hg, and
Yearly if systolic blood pressure reading of 120 to 139 mm Hg or diastolic blood pressure of 80 to 89 mm Hg
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Breast cancer
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All women
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Yearly mammogram and clinical breast exam*
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Cervical cancer
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An update to this recommendation is currently in progress and being reviewed by the U.S. Preventive Services Task Force (USPSTF). The recommendation below may contain information that is out of date. Please consult your health care provider.
Women who have been sexually active and have a cervix
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Please discuss with your health care provider.
The American Cancer Society (ACS) recommends a pap test every two years.
The American Congress of Obstetricians and Gynecologists (ACOG) currently recommends that women ages 30 and older get a pap tests once every three years, and women with certain risk factors (or at increased risk) may need more frequent screening.**
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Chlamydia
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Women at increased risk for infection
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At routine exams
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Colorectal cancer
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All adults
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Check with your health care provider.
Fecal occult blood testing, sigmoidoscopy, or colonoscopy is recommended as screening methods.
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Depression
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All adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up
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At routine exams
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Diabetes Mellitus, type 2
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Adults who are asymptomatic with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg
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At routine exams
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Gonorrhea
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Sexually active women at increased risk for infection
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At routine exams
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HIV
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Anyone at increased risk for infection
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At routine exams
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Lipid Disorders
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All women age 45 and older at increased risk for coronary artery disease
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At least every five years
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Obesity
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All adults
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At routine exams
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Osteoporosis, Postmenopausal Women
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An update to this recommendation is currently in progress and being reviewed by the USPSTF. The recommendation below may contain information that is out of date. Please discuss with your health care provider.
Women at age 60 who are at increased risk for osteoporotic fractures
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Please consult your health care provider.
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Syphilis
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Anyone at increased risk for infection
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At routine exams
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Tuberculosis
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Anyone at increased risk for infection
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Check with your health care provider.
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Counseling
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Who needs it
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How often
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Aspirin for prevention of cardiovascular events
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At-risk adults
Recommended for women age 55 to 79 years when the potential benefit of a reduction in ischemic strokes outweighs the potential harm of an increase in gastrointestinal hemorrhage.
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When risk is identified, and please discuss with your health care provider.
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Breast cancer, chemoprevention
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An update to this recommendation is currently in progress and being reviewed by the USPSTF. The recommendation below may contain information that is out of date. Please discuss with your health care provider.
Women with high risk
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The recommendation below may contain information that is out of date. Please consult your health care provider.
When risk is identified
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BRCA mutation testing for breast and ovarian cancer susceptibility
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Women with increased risk
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When risk is identified
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Diet, behavioral counseling
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Adults with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease
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When diagnosed
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Tobacco use and Tobacco-Caused Disease
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All adults
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Every visit
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Immunization
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Who needs it
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How often
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Tetanus/diphtheria/pertussis (Td/Tdap) booster
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All adults
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Td: Every 10 years
Tdap: Substitute a one-time dose of Tdap for a Td booster - Once after age 18
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Measles, mumps, rubella (MMR)
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All adults age 50 to 64 who lack prior infection or documented vaccinations***
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One dose
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Chickenpox (varicella)
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Adults age 50 to 64 and who lack prior infection or documented vaccinations***
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Two doses. The second dose should be administered four to eight weeks after the first dose.
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Flu vaccine (seasonal)
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All adults
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Yearly during flu season
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Hepatitis A vaccine
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People at risk***
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Two doses
Schedule:
Zero and 6 to 12 months (Havrix), OR
Zero and 6 to 18 months schedule (Vaqta)
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Hepatitis B vaccine
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People at risk***
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Three doses over six months
Second dose should be administered one month after the first dose; the third dose should be administered at least two months after the second dose (and at least four months after the first dose)
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Meningococcal
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People at risk***
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One or more doses
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Pneumococcal (polysaccharide)
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People at risk***
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One or two doses
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Zoster
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All women age 60 and older***
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One dose
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* Recommendation from the American Cancer Society (ACS). Currently, the U.S. Preventive Services Task Force (USPSTF) recommends screening every two years for women ages 50 to 74. The ACS recommends yearly screening for all women ages 40 and older. Women should talk with their doctors about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them. The ACS also recommends annual clinical breast exams (CBEs) for women ages 40 and older. The USPSTF, however, believes there is not enough evidence to assess the value of CBEs for women ages 40 and older. Women should talk with their doctors about their personal risk factors and make a decision about whether they should have a CBE.
** According to the American Congress of Obstetricians and Gynecologists (ACOG), women 30 and older who have had three consecutive negative Pap tests may be screened every three years.
