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Prevention Guidelines for Women 50–64

Here are the screening tests and immunizations that most women ages 50 to 64 need. A screening test is done to find possible health problems or diseases in people who don't have any symptoms. The goal is to find a disease early so lifestyle changes can be made and you can be watched more closely to lower the risk of disease, or to find it early enough to treat it most effectively. Screening tests are not diagnostic. But they are used to find out if more testing is needed. Health counseling is vital, too. You and your healthcare provider may decide that a different schedule is best for you. But this plan can guide your discussion.

Screening

Who needs it

How often

Type 2 diabetes or prediabetes

All adults starting at age 45 and adults without symptoms at any age who are overweight or obese and have 1 or more additional risk factors for diabetes

At least every 3 years

Alcohol misuse

All adults

At routine exams

Blood pressure

All adults

Yearly checkup if your blood pressure is normal.

 

Normal blood pressure is less than 120/80 mmHg.1

 

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

 

 Breast cancer

All women2

Yearly mammogram should be done until age 54. At age 55, switch to mammograms every other year. Or you may choose to continue yearly mammograms.2

Cervical cancer

All women, except those who have had a hysterectomy with removal of the cervix for reasons not related to cervical cancer and have no history of cervical cancer or serious precancer

Pap test every 3 years or Pap test with human papillomavirus (HPV) test every 5 years

Chlamydia

Women at a higher risk for infection

At routine exams

Colorectal cancer

All women of average risk in this age group

According to the American Cancer Society (ACS):

For tests that find polyps and cancer:

  • Flexible sigmoidoscopy every 5 years, or

  • Colonoscopy every 10 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 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 doctor 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 doctor about your health history and what colorectal cancer screening schedule is best for you.

Depression

All adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up

At routine exams

Gonorrhea

Sexually active women at a higher risk for infection

At routine exams if at risk

Hepatitis C

Adults at a higher risk; 1 time for those born between 1945 and 1965

At routine exams if at risk

HIV

All women

At routine exams if at risk

High cholesterol and triglycerides

All women ages 45 and older at a higher risk for coronary artery disease

At least every 5 years

Obesity

All adults

At routine exams

Lung cancer

Adults age 55 to 80 who have smoked

Yearly screening in smokers with 30-pack per year history of smoking or who quits within 15 years

Osteoporosis, postmenopausal women

Women at age 60 who are at a higher risk for fractures caused by osteoporosis

Check with your health care provider

Syphilis

Adults at a higher risk for infection

At routine exams if at risk

Tuberculosis

Adults at a higher risk for infection

Check with your healthcare provider.

Vision

All adults5

Check with your healthcare provider for exam frequency.

Counseling

Who needs it

How often

Aspirin for prevention of cardiovascular problems

At-risk adults

Recommended for women ages 55 to 79 years when the potential benefit of reducing strokes outweighs the potential harm of an increase in gastrointestinal bleeding

When risk is identified; talk with your healthcare provider before starting

Breast cancer, chemoprevention

Women at high risk

When risk is identified

BRCA mutation testing for breast and ovarian cancer susceptibility

Women with a higher risk

When risk is identified

Diet and exercise

Women who are overweight or obese

When diagnosed

Sexually transmitted disease prevention

Adults at a higher risk for infection

At routine exams

Tobacco use and tobacco-related disease

All adults

Every exam

Immunization

Who needs it

How often

Haemophilus influenzae B type

At risk adults

1 to 3 doses

Tetanus/diphtheria/
pertussis (Td/Tdap) booster)

All adults

One-time Tdap booster, then Td every 10 years

Measles, mumps, rubella (MMR)

Adults in this age group through their late 50s who have no previous infection or documented vaccinations6

1 to 2 doses

Chickenpox (varicella)

Adults ages 50 to 64 who have no previous infection or documented vaccinations6

2 doses; the second dose should be given at least 4 weeks after the first dose.

Flu vaccine (seasonal)

All adults

Yearly, when the vaccine becomes available in the community

Hepatitis A vaccine

People at risk7

2 doses given at least 6 months apart

Hepatitis B vaccine

High risk adults

3 doses; second dose should be given 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose)

Meningococcal

People at risk6

1 or more doses

Pneumococcal (PCV13)

Pneumococcal (PPSV23)

People at risk7

PCV13: 1 dose ages 19 to 65 (protects against 13 types of pneumococcal bacteria)

PPSV23: 1 to 2 doses through age 64, or 1 dose at 65 or older (protects against 23 types of pneumococcal bacteria)

Zoster

All women ages 60 and older6

1 dose

1. American College of Cardiology and the American Heart Association Task Force on Clinical Practice Guidelines

2. American Cancer Society

3. If the test is positive, a colonoscopy should be done.

4. The multiple stool take-home test should be used. One test done by the healthcare provider in the office is not adequate for testing. A colonoscopy should be done if the test is positive.

5. Recommendation from the American Academy of Ophthalmology

6. Exceptions may exist. Please check with your healthcare provider.

7. For complete list, see the CDC website.

Other guidelines from the USPSTF

Immunization schedule from the CDC

Online Medical Reviewer: Adler, Liora C, MD
Online Medical Reviewer: Cunningham, Louise, RN
Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Date Last Reviewed: 6/1/2018
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