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Health screening - women - over age 65

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

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

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 2 years.
  • 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.

CHOLESTEROL SCREENING AND HEART DISEASE PREVENTION

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

COLON CANCER SCREEN

Until age 75, you should be screened for colorectal cancer. There are several screening tests available. Some common screening tests include:

  • A fecal occult blood test every year
  • Flexible sigmoidoscopy every 5 years, along with a fecal occult blood test every 3 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 colon cancer or rectal cancer
  • A history of growths called adenomas

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.

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.

HEARING TEST

  • Have your hearing tested 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. 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.

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 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.

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

Advisory committee on immunization practices recommended immunization schedule for adults aged 19 years or older--United States, 2015. Kim DK, Bridges CB, Harriman KH; Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices (ACIP); ACIP Adult Immunization Work Group. MMWR Morb Mortal Wkly Rep. 2015 Feb 6;64(4):91-2. PMID: 25654609 www.ncbi.nlm.nih.gov/pubmed/25654609.

American Cancer Society. American Cancer Society guidelines for the early detection of cancer. Available at: www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer. Accessed July 24, 2015.

American College of Obstetricians-Gynecologists. Practice bulletin no. 122: Breast cancer screening. Obstet Gynecol. 2011 Aug;118(2 Pt 1):372-82. PMID: 21775869 www.ncbi.nlm.nih.gov/pubmed/21775869.

American College of Obstetricians and Gynecologists. Practice bulletin no. 131: Screening for cervical cancer. Obstet Gynecol. 2012;120:1222-38. PMID: 23090560 www.ncbi.nlm.nih.gov/pubmed/23090560.

American College of Obstetricians and Gynecologists. Committee opinion no. 463: Cervical cancer in adolescents: screening, evaluation, and management. Obstet Gynecol. 2010;116:469-72. PMID: 20664421 www.ncbi.nlm.nih.gov/pubmed/20664421.

American Dental Association. Questions about going to the dentist. Available at: www.mouthhealthy.org/en/dental-care-concerns/questions-about-going-to-the-dentist. Accessed Jul 24, 2015.

American Optometric Association. Comprehensive adult eye and vision examination. February 6, 2015. Available at: www.aoa.org/Documents/EBO/Adult%20Eye%20and%20Vision%20Examination%20Guideline%20Peer-Public%20Review%20Document.pdf. Accessed July 24, 2015.

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.

Breast Cancer Screening Draft Recommendations. U.S. Preventive Services Task Force. Available at www.screeningforbreastcancer.org/?ds=1&s=breast%2520cancer. Accessed July 24, 2015.

Cosman F, de Beur SJ, LeBoff MS, et al. Clinician's Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014 Oct;25(10):2359-81. PMID: 25182228 www.ncbi.nlm.nih.gov/pubmed/25182228.

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):507-20. PMID: 24352797 www.ncbi.nlm.nih.gov/pubmed/24352797.

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. PMID: 20722146 www.ncbi.nlm.nih.gov/pubmed/20722146.

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):1243-62. PMID: 21325087 www.ncbi.nlm.nih.gov/pubmed/21325087.

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Breast Cancer Screening and Diagnosis Version 3.2015. Available at: www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed July 24, 2015.

Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes? JAMA. 2014 Feb 5;311(5):474-6. PMID: 24352710 www.ncbi.nlm.nih.gov/pubmed/24352710.

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.

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. PMID: 22422631 www.ncbi.nlm.nih.gov/pubmed/22422631.

Screening for Cervical Cancer. U.S. Preventive Services Task Force. Available at www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening?ds=1&s=cervical%20cancer. Accessed July 24, 2015.

Smith RA, Brooks D, Cokkinides V, Saslow D, Brawley OW. Cancer screening in the United States, 2013. A review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin. 2013 Mar-Apr;63(2):88-105. PMID: 23378235 www.ncbi.nlm.nih.gov/pubmed/23378235.

Standards of medical care in diabetes--2015: summary of revisions. Diabetes Care. 2015 Jan;38 Suppl:S4. PMID: 25537706 www.ncbi.nlm.nih.gov/pubmed/25537706.

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. PMID: 24222016 www.ncbi.nlm.nih.gov/pubmed/24222016.

US Preventive Services TaskForce. Colorectal Cancer: Screening. 2008. www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/colorectal-cancer-screening. Accessed July 24, 2015.

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. Available at: www.archive.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide2012/abstract.html. Accessed July 24, 2015.

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          Review Date: 5/22/2015

          Reviewed 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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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