Children's Health and Wellness

Prevention Guidelines for Women 50–64

Here are the screening tests and immunizations that most women ages 50 to 64 need. Although you and your health care provider may decide that a different schedule is best for you, this plan can guide your discussion.

Screening

Who needs it

How often

Alcohol misuse

All adults

At routine exams

Blood pressure

All adults

Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends the following screening schedules:

  • Every 2 years if blood pressure reading < 120/80 mm Hg, or

  • Yearly if systolic blood pressure reading of 120 to 139 mm Hg or diastolic blood pressure reading of 80 to 89 mm Hg

Breast cancer

All women

Yearly mammogram and clinical breast exam*

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

Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called “co-testing”) every 5 years. This is the preferred approach, but it is also acceptable to continue to have Pap tests alone every 3 years.

Chlamydia

Women at increased risk for infection

At routine exams

Colorectal cancer

All adults starting at age 50

According to the American Cancer Society (ACS):

For tests that find polyps and cancer:

  • Flexible sigmoidoscopy every 5 years1, or

  • Colonoscopy every 10 years, or

  • Double-contrast barium enema every 5 years1

For tests that primarily find cancer:

  • Yearly fecal occult blood test2, or

  • Yearly fecal immunochemical test every year2, or

  • Stool DNA test, interval uncertain2

The tests that are designed to find both early cancer and polyps are preferred if these tests are available to you and you are willing to have one of these more invasive tests; talk with your doctor about which test 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

Diabetes mellitus, type 2

Adults who have no symptoms and have sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg

At least every 3 years

Gonorrhea

Sexually active women at increased risk for infection

At routine exams if at risk

HIV

Anyone at increased risk for infection

At routine exams if at risk

Lipid disorders

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

At least every 5 years

Obesity

All adults

At routine exams

Osteoporosis, postmenopausal women

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

Check with your health care provider

Syphilis

Anyone at increased risk for infection

At routine exams if at risk

Tuberculosis

Anyone at increased risk for infection

Check with your health care provider

Vision

All adults3

Check with your health care 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 ischemic strokes outweighs the potential harm of an increase in gastrointestinal hemorrhage

When risk is identified; discuss with your health care 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 increased risk

When risk is identified

Diet, behavioral counseling

Adults with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease

When diagnosed

Tobacco use and tobacco-related disease

All adults

Every visit

Immunization

Who needs it

How often

Tetanus/diphtheria/pertussis (Td/Tdap) booster

All adults

Td: every 10 years

Tdap: substitute a one-time dose of Tdap for a Td booster after age 18, then boost with Td every 10 years

Measles, mumps, rubella (MMR)

All adults ages 50 to 64 who have no previous infection or documented vaccinations**

One dose

Chickenpox (varicella)

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

Two 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 risk4

Two doses given at least 6 months apart

Hepatitis B vaccine

People at risk5

Three 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 risk**

One or more doses

Pneumococcal (polysaccharide)

People at risk6

One or two doses

Zoster

All women ages 60 and older**

One dose

*Recommendation from the ACS. Currently, the U.S. Preventive Services Task Force (USPSTF) recommends screening every 2 years for women ages 50 to 74. The ACS recommends yearly screening for all women ages 40 and older. Women should talk with their doctors about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them. The ACS also recommends annual clinical breast exams (CBEs) for women ages 40 and older. The USPSTF, however, believes there is not enough evidence to assess the value of CBEs for women ages 40 and older. Women should talk with their doctors about their personal risk factors and make a decision about whether they should have a CBE.

**Exceptions may exist, please check with your health care provider

1If the test is positive, a colonoscopy should be done

2The multiple stool take-home test should be used. One test done by the doctor in the office is not adequate for testing. A colonoscopy should be done if the test is positive.

3Recommendation from the American Academy of Ophthalmology

4For complete list, see the CDC website

5For complete list, see the CDC website

6For complete list, see the CDC website

Other guidelines are from the USPSTF

Immunization schedule from the CDC

Online Source: American Congress of Obstetricians and Gynecologistshttp://www.acog.org/from_home/publications/press_releases/nr11-20-09.cfm
Online Source: Agency for Healthcare Research and Qualityhttp://www.ahrq.gov/Clinic/cps3dix.htm
Online Source: U.S. Preventive Services Task Forcehttp://www.ahrq.gov/clinic/cvd/hbppatient.htm
Online Source: Agency for Healthcare Research http://www.ahrq.gov/clinic/pocketgd09/gcp09s2.htm
Online Source: Agency for Healthcare Research and Qualityhttp://www.ahrq.gov/clinic/pocketgd09/pocketgd09.pdf
Online Source: Agency for Healthcare Research and Qualityhttp://www.ahrq.gov/clinic/pocketgd1011/pocketgd1011.pdf
Online Source: Agency for Healthcare Research and Qualityhttp://www.ahrq.gov/clinic/USpstf/uspsbrca.htm
Online Source: Agency for Healthcare Research http://www.ahrq.gov/clinic/uspstf07/hbp/hbprs.htm
Online Source: Agency for Healthcare Research and Qualityhttp://www.ahrq.gov/clinic/uspstfix.htm
Online Source: Agency for Healthcare Research and Qualityhttp://www.ahrq.gov/news/press/pr2011/tfosteopr.htm
Online Source: Agency for Healthcare Research and Qualityhttp://www.ahrq.gov/ppip/healthywom.htm
Online Source: Annals of Internal Medicinehttp://www.annals.org/content/147/11/783.full
Online Source: American Cancer Societyhttp://www.cancer.org/Cancer/CervicalCancer/DetailedGuide/cervical-cancer-prevention
Online Source: American Cancer Societyhttp://www.cancer.org/docroot/CRI/content/CRI_2_6x_cervical_cancer_prevention_and_early_detection_8.asp?sitearea=PED
Online Source: American Cancer Societyhttp://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer
Online Source: Centers for Disease Control and Preventionhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm5901a5.htm
Online Source: CDChttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6104a9.htm
Online Source: U.S. Preventive Services Task Forcehttp://www.uspreventiveservicestaskforce.org/adultrec.htm
Online Source: U.S. Preventive Servces Task Forcehttp://www.uspreventiveservicestaskforce.org/recommendations.htm
Online Source: Agency for Healthcare Research and Qualityhttp://www.uspreventiveservicestaskforce.org/uspstf/uspsasmi.htm
Online Source: Agency for Healthcare Research and Qualityhttp://www.uspreventiveservicestaskforce.org/uspstf/uspschol.htm
Online Source: Agency for Healthcare Research http://www.uspreventiveservicestaskforce.org/uspstf/uspshype.htm
Online Editor: Sinovic, Dianna
Online Medical Reviewer: Berry, Judith, PhD, APRN
Online Medical Reviewer: Fraser, Marianne, MSN, RN
Online Medical Reviewer: Godsey, Cynthia, MSN, APRN, MSHE, FNP-BC
Online Medical Reviewer: Stump-Sutliff, Kimberly, RN, MSN, AOCNS
Date Last Reviewed: 3/22/2012
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