Patient Resources

Health Screening Guidelines for Women 65+

Here are the health screenings that most women at age 65 and older need. Although you and your healthcare provider may decide that a different schedule is best for you, this plan can guide your discussion. In addition, major organizations may vary in recommendations on these prevention guidelines.

Screening	Who needs it	How often
Type 2 diabetes or prediabetes	All adults starting at age 35 and adults without symptoms at any age who are overweight or obese and have one or more additional risk factors for diabetes	At least every 3 years
Alcohol use or misuse	All adults	At routine exams
Blood pressure	All adults	Every year if your blood pressure reading is less than 120/80 mm Hg If your blood pressure reading is higher than normal, follow the advice of your healthcare provider
Breast cancer	All women of average risk. Expert groups vary on their advice. Talk with your provider about your specific situation.	A mammogram should be done every 1 or 2 years. Talk with your provider about your risk factors. Ask how often you need the test. Ask what age you can stop. The U.S. Preventive Services Task Force advises a mammogram every 2 years through age 74. The American Cancer Society advises screening every 1 to 2 years for women 55 and older. They advise screening to continue as long as a woman is healthy and expected to live 10 more years or longer. All women should know how their breasts normally look and feel. They should know the benefits and risks of breast cancer screening with mammograms.
Cervical cancer	According to the American Cancer Society (ACS), women older than 65 who have had regular screening with normal results over the past 10 years do not need to be screened for cervical cancer. Once screening is stopped, it should not be started again. Those with a history of serious cervical precancer should continue to be tested for 25 years after that diagnosis, even if testing goes past 65.	Discuss with your healthcare provider
Chlamydia	Women at increased risk for infection	At routine exams if at risk
Colorectal cancer	All women of average risk and in good health in this age group, through age 75. For women ages 76 to 85, talk with your healthcare provider about continued screening. For women 85 and older, experts don't advise screening.	The ACS recommends: Several tests are available and used at different times. For tests that find polyps and cancer: Colonoscopy every 10 years (recommended), or Flexible sigmoidoscopy every 5 years, or CT colonography (virtual colonoscopy) every 5 years For tests that primarily find cancer: Yearly fecal occult blood test or Yearly fecal immunochemical test every year, or Stool fecal immunochemical test plus DNA test, every 3 years You will need a follow-up colonoscopy if you choose any test other than a colonoscopy and you have an abnormal result. Screening recommendations vary among expert groups. Talk with your healthcare provider about which test is best for you. Some people should be screened using a different schedule because of their personal or family history. Talk with your healthcare provider about your health history and what colorectal cancer screening schedule is best for you.
Depression	All adults who have access to a clinical practice that has staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up	At routine exams
Gonorrhea	Sexually active women who are at increased risk for infection	At routine exams if at risk
HIV	Anyone at increased risk for infection	At routine exams if at risk
Hepatitis C	Anyone at increased risk; one time for those born between 1945 and 1965	At routine exams
High cholesterol and triglycerides	All women ages 20 and older at increased risk for coronary artery disease	At least every 5 years, or more frequently if recommended by your healthcare provider
Lung cancer	Women between the ages of 50 and 80 who are in fairly good health, are at higher risk for lung cancer, and who: Currently smoke or have quit smoking , and Have a 20-pack year history of smoking (1 pack/day for 20 years or 2 packs/day for 10 years)	Yearly lung cancer screening with a low-dose CT scan (LDCT). Talk with your healthcare provider about your risk and situation
Obesity	All adults	At routine exams
Osteoporosis, postmenopausal	All women ages 65 and older	Bone density test at age 65, then follow-up as recommended by healthcare provider
Syphilis	Anyone at increased risk for infection	At routine exams if at risk
Tuberculosis	Anyone at increased risk for infection	Check with your healthcare provider
Vision	All adults	Every 1 to 2 years. If you have a chronic disease, check with your healthcare provider for exam frequency

Screening

Who needs it

How often

Type 2 diabetes or prediabetes

All adults starting at age 35 and adults without symptoms at any age who are overweight or obese and have one or more additional risk factors for diabetes

At least every 3 years

Alcohol use or misuse

All adults

At routine exams

Blood pressure

All adults

Every year if your blood pressure reading is less than 120/80 mm Hg

If your blood pressure reading is higher than normal, follow the advice of your healthcare provider

Breast cancer

All women of average risk. Expert groups vary on their advice. Talk with your provider about your specific situation.

A mammogram should be done every 1 or 2 years. Talk with your provider about your risk factors. Ask how often you need the test. Ask what age you can stop.

The U.S. Preventive Services Task Force advises a mammogram every 2 years through age 74.
The American Cancer Society advises screening every 1 to 2 years for women 55 and older. They advise screening to continue as long as a woman is healthy and expected to live 10 more years or longer.

All women should know how their breasts normally look and feel. They should know the benefits and risks of breast cancer screening with mammograms.

Cervical cancer

According to the American Cancer Society (ACS), women older than 65 who have had regular screening with normal results over the past 10 years do not need to be screened for cervical cancer. Once screening is stopped, it should not be started again. Those with a history of serious cervical precancer should continue to be tested for 25 years after that diagnosis, even if testing goes past 65.

Discuss with your healthcare provider

Chlamydia

Women at increased risk for infection

At routine exams if at risk

Colorectal cancer

All women of average risk and in good health in this age group, through age 75. For women ages 76 to 85, talk with your healthcare provider about continued screening. For women 85 and older, experts don't advise screening.

The ACS recommends:

Several tests are available and used at different times.

For tests that find polyps and cancer:

Colonoscopy every 10 years (recommended), or
Flexible sigmoidoscopy every 5 years, or
CT colonography (virtual colonoscopy) every 5 years

For tests that primarily find cancer:

Yearly fecal occult blood test or
Yearly fecal immunochemical test every year, or
Stool fecal immunochemical test plus DNA test, every 3 years

You will need a follow-up colonoscopy if you choose any test other than a colonoscopy and you have an abnormal result. Screening recommendations vary among expert groups.

Talk with your healthcare provider about which test is best for you.

Some people should be screened using a different schedule because of their personal or family history. Talk with your healthcare provider about your health history and what colorectal cancer screening schedule is best for you.

Depression

All adults who have access to a clinical practice that has staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up

At routine exams

Gonorrhea

Sexually active women who are at increased risk for infection

At routine exams if at risk

HIV

Anyone at increased risk for infection

At routine exams if at risk

Hepatitis C

Anyone at increased risk; one time for those born between 1945 and 1965

At routine exams

High cholesterol and triglycerides

All women ages 20 and older at increased risk for coronary artery disease

At least every 5 years, or more frequently if recommended by your healthcare provider

Lung cancer

Women between the ages of 50 and 80 who are in fairly good health, are at higher risk for lung cancer, and who:

Currently smoke or have quit smoking , and
Have a 20-pack year history of smoking (1 pack/day for 20 years or 2 packs/day for 10 years)

Yearly lung cancer screening with a low-dose CT scan (LDCT). Talk with your healthcare provider about your risk and situation

Obesity

All adults

At routine exams

Osteoporosis, postmenopausal

All women ages 65 and older

Bone density test at age 65, then follow-up as recommended by healthcare provider

Syphilis

Anyone at increased risk for infection

At routine exams if at risk

Tuberculosis

Anyone at increased risk for infection

Check with your healthcare provider

Vision

All adults

Every 1 to 2 years. If you have a chronic disease, check with your healthcare provider for exam frequency

Counseling	Who needs it	How often
Diet and exercise	Adults who are overweight or obese	When diagnosed and at routine exams
Fall prevention (exercise, vitamin D supplements)	All women in this age group	At routine exams
Sexually transmitted diseases prevention	All women at increased risk	At routine exams
Tobacco use and tobacco-related disease	All adults	Every exam

Counseling

Who needs it

How often

Diet and exercise

Adults who are overweight or obese

When diagnosed and at routine exams

Fall prevention (exercise, vitamin D supplements)

All women in this age group

At routine exams

Sexually transmitted diseases prevention

All women at increased risk

At routine exams

Tobacco use and tobacco-related disease

All adults

Every exam