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Health screening - women - over age 65

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 of future medical problems
  • Encourage a healthy lifestyle
  • Update vaccinations
  • Help you get to know your provider in case of an illness

Alternative Names

Health maintenance visit - women - over age 65; Physical exam - women - over age 65; Yearly exam - women - over age 65; Checkup - women - over age 65; Women's health - over age 65; Preventive care exam - women - over age 65

Information

Even if you feel fine, you should still see your health care 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 over age 65:

BLOOD PRESSURE SCREENING

  • Have your blood pressure checked every year.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.

CHOLESTEROL SCREENING AND HEART DISEASE PREVENTION

  • If your cholesterol level is normal, have it rechecked every 3 to 5 years.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.

COLON CANCER SCREENING

Until age 75, you should have one of the following screening tests:

You may need a colonoscopy more often if you have risk factors for colon cancer, including:

DENTAL EXAM

  • Go to the dentist every year for an exam and cleaning.

DIABETES SCREENING

  • If you are age 65 or older and in good health, you should be screened for diabetes every 3 years.
  • If you are overweight and have other risk factors for diabetes, ask your doctor if you should be screened more often.

EYE EXAM

  • Have an eye exam every 1 to 2 years if you have vision problems or glaucoma  risk.

HEARING TEST

  • Have your hearing tested every year if you have symptoms of hearing loss.

IMMUNIZATIONS

  • If you are over age 65, get a pneumococcal vaccine if you have never had one, or if you received one more than 5 years before you turned 65.
  • Get a flu shot every year.
  • Get a tetanus-diphtheria booster every 10 years.
  • You may get a shingles or herpes zoster vaccination once after age 60.

PHYSICAL EXAM

  • Have a yearly physical exam.
  • With each exam, your provider will check your height, weight, and body mass index (BMI).
  • Routine diagnostic tests are not recommended unless your provider finds a problem.

During the exam, your provider will ask questions about:

  • Your medicines and risk of interactions
  • Alcohol and tobacco use
  • Diet and exercise
  • Safety, such as seat belt use
  • Depression

BREAST EXAMS

  • Women may do a monthly breast self-exam.
  • Contact your provider right away if you notice a change in your breasts, whether or not you do self-exams.
  • Your provider may do a complete breast exam during your preventive exam. Experts do not agree on the benefit of a breast examination.

MAMMOGRAM

  • Women up to age 75 should have a mammogram every 1 to 2 years, depending on their risk factors, to check for breast cancer .
  • Experts do not agree on the benefits of having a mammogram for women age 75 and older. Some do not recommend having mammograms after this age. Others recommend mammography for women in good health. Talk to your provider about what is best for you.

OSTEOPOROSIS SCREENING

PELVIC EXAM AND PAP SMEAR

  • After age 65, most women can stop having Pap smears as long as they have had 3 negative tests within the past 10 years.

LUNG CANCER SCREENING

The U.S. Preventive Services Task Force recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults until age 80 who:

  • Have a 30 pack-year smoking history AND
  • Currently smoke or have quit within the past 15 years

References

American College of Obstetricians and Gynecologists. Committee opinion no. 463: Cervical cancer in adolescents: screening, evaluation, and management. Obstet Gynecol. 2010;116:469-472.

American College of Obstetricians and Gynecologists. Practice bulletin no.122: Breast cancer screening. Obstet Gynecol. 2011;118:372-82.

American College of Obstetricians and Gynecologists. Practice Bulletin No. 99: Management of abnormal cervical cytology and histology. Obstet Gynecol. 2008;112:1419-1444.

American College of Obstetricians and Gynecologists. Practice bulletin no. 131: Screening for cervical cancer. Obstet Gynecol. 2012;120:1222-1238.

American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37 Suppl 1:S14-S80.

Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 14.

Centers for Disease Control and Prevention. Recommended Immunization Schedule for Adults, United States, 2014. Available at http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule.pdf. Accessed July 24, 2014.

Gaziano M, Ridker PM, Libby P. Primary and secondary prevention of coronary heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders; 2012:1010.

Handler J, 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 Feb 5;311(5):507-520.

Helfand M, Carson S. Screening for Lipid Disorders in Adults: Selective Update of 2001 US Preventive Services Task Force Review. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Jun.

Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women--2011 update: A guideline from the American Heart Association. Circulation. 2011;123(11):1243-1262.

Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes? JAMA. 2014 Feb 5;311(5):474-476.

Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2012;62(3):147-72.

Screening for Breast Cancer. U.S. Preventive Services Task Force. Available at http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm. Accessed July 24, 2014.

Screening for Cervical Cancer. U.S. Preventive Services Task Force. Available at http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm. Accessed July 24, 2014.

Smith RA, Cokkinides V, Brooks D, Saslow D, Brawley OW. Cancer screening in the United States, 2010. A review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin. 2010; 60(2):99-119.

Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz N,  Blum CB, et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. Circulation. 2014 Jun 24;129(25 Suppl 2):S1-S45.

U.S. Preventive Services Task Force. The Guide to Clinical Preventive Services. 2010-2011. AHRQ Publication No. 10-05145, September 2010. Agency for Healthcare Research and Quality, Rockville, MD.

Updated: 8/8/2014

Deborah Greenberg, MD, Associate Professor of Medicine, Division of General Internal Medicine, University of Washington, Seattle, WA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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