Health screening - 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 and other preventive care services
- Help you get to know your provider in case of an illness
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 provider 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
- You had high blood pressure during a pregnancy
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
After starting cervical cancer screening:
- 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 or precancer (high grade cervcial neoplasia), you do not need cervical cancer screening.
Cholesterol screening should begin at:
- Age 45 for women with no known risk factors for coronary heart disease
- Age 20 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:
- Ulcerative colitis
- A personal or family history of colorectal cancer
- A history of growths in your 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.
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
- 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.
Commonly needed vaccines include:
- Flu shot: get one every year.
- COVID-19 vaccine - ask your provider what is best for you
- 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
If you are age 50 to 64 and have risk factors for osteoporosis, you should discuss screening with your provider.
Risk factors can include long-term steroid use, low body weight, smoking, heavy alcohol use, having a fracture after age 50, or a family history of hip fracture or osteoporosis.
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 and other preventive care services
- 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
- Your medicines and risk for interactions
- 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.
Advisory Committee on Immunization Practices. Adult immunization scheduleby age. Recommendations for ages 19 years or older, United States, 2023.www.cdc.gov/vaccines/schedules/hcp/imz/adult.html. Updated April 27, 2023.Accessed July 30, 2023.
American Academy of Ophthalmology website. Comprehensive adult medical eyeexamination PPP 2020.www.aao.org/education/preferred-practice-pattern/comprehensive-adult-medical-eye-evaluation-ppp.Updated November 2020. Accessed July 30, 2023.
American Cancer Society website. Breast cancer early detection anddiagnosis: American Cancer Society recommendations for the early detection ofbreast 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 July 30, 2023.
American College of Obstetricians and Gynecologists(ACOG) website. FAQ178: Mammography and other screening tests for breastproblems.www.acog.org/patient-resources/faqs/gynecologic-problems/mammography-and-other-screening-tests-for-breast-problems.Updated July 2022. Accessed July 30, 2023.
American College ofObstetricians and Gynecologists. FAQ163: Cervical cancer.www.acog.org/patient-resources/faqs/gynecologic-problems/cervical-cancer.Updated April 2021. Accessed July 30, 2023.American DentalAssociation 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 July 30, 2023.
American Diabetes AssociationProfessional Practice Committee. 2. Classification and Diagnosis of Diabetes:Standards of Medical Care in Diabetes-2023. Diabetes Care. 2023 Jan1;46(Suppl 1):S19-S30. PMID: 36507649. pubmed.ncbi.nlm.nih.gov/36507649/.
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 theAmerican College of Obstetricians and Gynecologists. Promoting riskidentification and reduction of cardiovascular disease in women throughcollaboration with obstetricians and gynecologists: a presidential advisoryfrom the American Heart Association and the American College of Obstetriciansand Gynecologists. Circulation. 2018;137(24):e843-e852. PMID: 29748185pubmed.ncbi.nlm.nih.gov/29748185/.
Grundy SM, Stone NJ, Bailey AL, et al. 2018AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on themanagement of blood cholesterol: a report of the American College ofCardiology/American Heart Association Task Force on Clinical PracticeGuidelines [published correction appears in J Am Coll Cardiol. 2019 Jun25;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 StrokeCouncil; et al. Guidelines for the primary prevention of stroke: a statementfor healthcare professionals from the American Heart Association/AmericanStroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838pubmed.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'sHeart Disease: A Textbook of Cardiovascular Medicine. 12th ed.Philadelphia, PA: Elsevier; 2022:chap 25.National Cancer Institute website. Breast cancer screening (PDQ) - healthprofessional version. www.cancer.gov/types/breast/hp/breast-screening-pdq.Updated June 7, 2023. Accessed July 30, 2023.
Studenski S, Van Swearingen J. Falls. In: Fillit HM, Rockwood K, Young J,eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8thed. Philadelphia, PA: Elsevier; 2017:chap 103.US Preventive Services Task Force website. A and B recommendations.www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations.Accessed July 30, 2023.
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 July 30, 2023.
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 July 30, 2023.
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 July 30, 2023.
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 July 30, 2023.
US Preventive Services Task Force website. Falls prevention in community-dwellingolder adults: Interventions. www.uspreventiveservicestaskforce.org/uspstf/recommendation/falls-prevention-in-older-adults-interventions.Published April 17, 2018. Accessed July 30, 2023.
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 July 30, 2023.
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 July 30, 2023.
US Preventive Services Task Force website. Hypertension in adults:Screening.www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening.Published April 27, 2021. Accessed July 30, 2023.
US Preventive Services Task Force website. Final recommendation statement:Lung cancer: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening.Updated March 9, 2021. Accessed July 30, 2023.
US Preventive Services Task Force website. Final recommendation statement:Osteoporosis to prevent fractures: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening.Updated June 26, 2018. Accessed July 30, 2023.
US Preventive Services Task Force website. Prediabetes and type 2diabetes: Screening.www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes.Updated August 24, 2021. Accessed July 30, 2023.
US Preventive Services Task Force website. Skin cancer: Screening.www.uspreventiveservicestaskforce.org/uspstf/recommendation/skin-cancer-screening.Updated April 18, 2023. Accessed July 30, 2023.
Whelton PK, Carey RM, Mancia G, Kreutz R, Bundy JD,Williams B. Harmonization of the American College of Cardiology/American HeartAssociation and European Society of Cardiology/European Society of HypertensionBlood Pressure/Hypertension Guidelines: Comparisons, Reflections, andRecommendations. Circulation. 2022;146:868–877. DOI:10.1161/CIRCULATIONAHA.121.054602.
Last reviewed on: 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. Editorial update 04/18/2023. Internal review and update on 08/01/23.