Health screenings for women over age 65: MedlinePlus Medical Encyclopedia

P 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

T Information
P 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.
P There are specific times when you should see your provider. Below are screening guidelines for women over age 65.
P BLOOD PRESSURE SCREENING
- Have your blood pressure checked 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 greater than 140, or the bottom number is greater than 90, schedule an appointment with your provider.
- If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.
- Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked.
P 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.
P COLON CANCER SCREEN
P Until age 75, you should have one of the following screening tests:
- A fecal occult blood (stool-based) test every year
- Flexible sigmoidoscopy every 10 years, along with a fecal occult blood test every year
- Colonoscopy every 10 years
P You may need a colonoscopy more often if you have risk factors for colon cancer, including:
- Ulcerative colitis
- A personal or family history of colon cancer or rectal cancer
- A history of growths called adenomatous polyps
P DENTAL EXAM
- 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.
P 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 provider if you should be screened more often.
P EYE EXAM
- Have an eye exam every 1 to 2 years.
- Have an eye exam at least every year if you have diabetes.
P HEARING TEST
- Have your hearing tested if you have symptoms of hearing loss.
P IMMUNIZATIONS
- If you are over age 65, get a pneumococcal vaccine if you have never had one, or if it has been more than 5 years since you had the vaccine.
- 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.
P 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.
P 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
- Depression
P BREAST EXAMS
- 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.
- 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 clinical breast exam during your preventive exam. Experts do not agree on the benefit of a breast examination.
P 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.
P OSTEOPOROSIS SCREENING
- All women over age 64 should have a bone density test (DEXA scan).
- Ask your provider which exercises can help prevent osteoporosis.
P PELVIC EXAM AND PAP SMEAR
- 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 3 negative tests within the past 10 years.
P LUNG CANCER SCREENING
P The US 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

T Alternative Names
P 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

T Images
- Fecal occult blood test

T References
P American College of Obstetricians and Gynecologists. Practice bulletin no. 157: cervical cancer screening and prevention. Obstet Gynecol. 2016;127(1):e1-e20. PMID: 26695583 www.ncbi.nlm.nih.gov/pubmed/26695583.
P American Academy of Ophthalmology. Policy statement: frequency of ocular examinations - 2015. AAO.org Web site. www.aao.org/clinical-statement/frequency-of-ocular-examinations. Accessed June 9, 2017.
P American Dental Association. Your Top 9 questions about going to the dentist – answered. Mouthhealthy.org Web site. www.mouthhealthy.org/en/dental-care-concerns/questions-about-going-to-the-dentist. Accessed June 9, 2017.
P American Diabetes Association. Standards of medical care in diabetes – 2017. Diabetes Care. 2017;40(Suppl 1):S1-S98. http://care.diabetesjournals.org/content/40/Supplement_1.
P Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 15.
P Cosman F, de Beur SJ, LeBoff MS, et al. Clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int. 2014;25(10):2359-2381. PMID: 25182228 www.ncbi.nlm.nih.gov/pubmed/25182228.
P James PA, Oparil S, Carter BL, 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;311(5):507-520. PMID: 24352797 www.ncbi.nlm.nih.gov/pubmed/24352797.
P Kim DK, Riley LE, Harriman KH, Hunter P, Bridges CB; Advisory Committee on Immunization Practices (ACIP), ACIP Adult Immunization Work Group. Advisory Committee on Immunization Practices recommended immunization schedule for adults aged 19 years or older -- United States, 2017. MMWR Morb Mortal Wkly Rep. 2017;66(5):136-138. PMID: 28182599 www.ncbi.nlm.nih.gov/pubmed/28182599.
P Meschia JF, Bushnell C; 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 www.ncbi.nlm.nih.gov/pubmed/25355838.
P Mosca L, Benjamin EJ, Berra K, 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. PMID: 21325087 www.ncbi.nlm.nih.gov/pubmed/21325087.
P Moyer VA; U.S. Preventive Services Task Force. Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330-338. PMID: 24378917 www.ncbi.nlm.nih.gov/pubmed/24378917.
P Ridker PM, Libby P, Burning JE. Risk Markers and the primary prevention of cardiovascular disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 42.
P 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):147-172. PMID: 22422631 www.ncbi.nlm.nih.gov/pubmed/22422631.
P Siu AL; US Preventive Services Task Force. Screening for high blood pressure in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163(10):778-786. PMID: 26458123 www.ncbi.nlm.nih.gov/pubmed/26458123.
P Siu AL; U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164(4):279-296. PMID: 26757170 www.ncbi.nlm.nih.gov/pubmed/26757170.
P Smith RA, Andrews KS, Brooks D, et al. Cancer screening in the United States, 2017: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2017;67(2):100-121. PMID 28170086 www.ncbi.nlm.nih.gov/pubmed/28170086.
P Stone NJ, Robinson JG, Lichtenstein AH, et al.; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S1-S45. PMID: 24222016 www.ncbi.nlm.nih.gov/pubmed/24222016.

T Review Date 5/21/2017
P Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

