Health screenings for women age 65 and older
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
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
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. Below are screening guidelines for women age 65 and older.
BLOOD PRESSURE SCREENING
- Have your blood pressure checked at least once every year. If the top number (systolic number) is between 120 and 139 or the bottom number (diastolic number) is between 80 and 89 mm Hg or higher, have it checked every year.
- If the top number is 130 or greater or the bottom number is 80 or greater, schedule an appointment with your provider to learn how you can reduce your blood pressure.
- If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to have your blood pressure checked more often, but still at least once a year.
- Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked.
BREAST CANCER SCREENING
- Women may do a monthly breast self-exam. However, 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.
- Your provider may do a clinical breast exam during your preventive exam. Experts do not agree on the benefit of a breast examination.
- 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.
CERVICAL CANCER SCREENING
- After age 65, most women who have not been diagnosed with cervical cancer or precancer can stop having Pap smears as long as they have had three negative tests within the past 10 years.
CHOLESTEROL SCREENING AND HEART DISEASE PREVENTION
- If your cholesterol level is normal, have it rechecked at least every 5 years.
- If you have high cholesterol, diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.
COLORECTAL CANCER SCREENING
Until age 75, you should have screening for colorectal cancer on a regular basis. If you are age 76 or older, you should ask your doctor if you should receive screening. Several tests are available for colorectal cancer screening:
- A fecal occult blood (stool-based) test every year
- A fecal immunochemical test (FIT) every year
- A stool DNA test every 3 years
- Flexible sigmoidoscopy every 5 years
- Double contrast barium enema every 5 years
- CT colonography (virtual colonoscopy) every 5 years
- Colonoscopy every 10 years
You may need a colonoscopy more often if you have risk factors for colon cancer, including:
- Ulcerative colitis
- A personal or family history of colorectal cancer
- A history of growths 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.
- 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 provider if you should be screened more often.
- Have an eye exam every 1 to 2 years.
- Have an eye exam at least every year if you have diabetes.
- Have your hearing tested if you have symptoms of hearing loss.
- If you are over age 65, get pneumococcal vaccines.
- Get a flu shot every year.
- Get a tetanus-diphtheria booster every 10 years.
- You may get a shingles or herpes zoster vaccination at age 50 or older.
INFECTIOUS DISEASE SCREENING
- The US Preventive Services Task Force recommends screening for hepatitis C. Depending on your lifestyle and medical history, you may need to be screened for infections such as syphilis, chlamydia, and HIV, as well as other infections.
LUNG CANCER SCREENING
You should have an annual screening for lung cancer with low-dose computed tomography (LDCT) if:
- You are over age 55 AND
- You have a 30 pack-year smoking history AND
- You currently smoke or have quit within the past 15 years
- All women over age 64 should have a bone density test (DEXA scan).
- Ask your provider which exercises or other interventions can help prevent osteoporosis.
- 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 for interactions
- Alcohol and tobacco use
- Diet and exercise
- Safety, such as seat belt use
- Whether you have had falls
- 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. Recommended immunization schedule for adults aged 19 years or older, United States, 2020. www.cdc.gov/vaccines/schedules/index.html. Updated February 3, 2020. Accessed April 18, 2020.
American Academy of Ophthalmology website. Policy statement: frequency of ocular examinations - 2015. www.aao.org/clinical-statement/frequency-of-ocular-examinations. Updated March 2015. Accessed April 18, 2020.
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 March 5, 2020. Accessed April 18, 2020.
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 September 2017. Accessed April 18, 2020.
American College of Obstetricians and Gynecologists. FAQ163: Cervical cancer. www.acog.org/patient-resources/faqs/gynecologic-problems/cervical-cancer. Updated December 2018. Accessed April 18, 2020.
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 April 18, 2020.
American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes - 2020. Diabetes Care. 2020;43(Suppl 1):S14–S31. PMID: 31862745 pubmed.ncbi.nlm.nih.gov/31862745/.
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/.
Moyer VA; US Preventive Services Task Force. Screening for lung cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330-338. PMID: 24378917 pubmed.ncbi.nlm.nih.gov/24378917/.
Ridker PM, Libby P, Buring JE. Risk markers and the primary prevention of cardiovascular disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 45.
Siu AL; US Preventive Services Task Force. Screening for breast cancer: US Preventive Services Task Force recommendation statement [published correction appears in Ann Intern Med. 2016 Mar 15;164(6):448]. Ann Intern Med. 2016;164(4):279-296. PMID: 26757170 pubmed.ncbi.nlm.nih.gov/26757170/.
Siu AL; US Preventive Services Task Force. Screening for high blood pressure in adults: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163(10):778-786. PMID: 26458123 pubmed.ncbi.nlm.nih.gov/26458123/.
Smith RA, Andrews KS, Brooks D, et al. Cancer screening in the United States, 2019: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2019;69(3):184-210. PMID: 30875085 pubmed.ncbi.nlm.nih.gov/30875085/.
Studenski S, Van Swearingen J. Falls. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier; 2017:chap 103.
US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for skin cancer: US Preventive Services Task Force recommendation statement. JAMA. 2016;316(4):429-435. PMID: 27458948 pubmed.ncbi.nlm.nih.gov/27458948/.
US Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening for osteoporosis to prevent fractures: US Preventive Services Task Force recommendation statement. JAMA. 2018;319(24):2521-2531. PMID: 29946735 pubmed.ncbi.nlm.nih.gov/29946735/.
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 April 18, 2020.
US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Published June 15, 2016. Accessed April 18, 2020.
US Preventive Services Task Force website. Hepatitis C virus infection in adolescents and adults: screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/hepatitis-c-screening. Published March 2, 2020. Accessed April 18, 2020.
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/.