Staying healthy is not the most difficult thing you’ll ever do, but it does take some effort and vigilance. One part of that effort is getting appropriate screening tests, which are used to detect potential health problems when they’re still treatable.
The screening tests you’ll need will change as you age. Once you start a test, it will likely be required periodically for the rest of your life.
20s and 30s
Pelvic exam and Pap smear
Regardless of sexual history, women aged 21 and older should have a Pap smear every three years. The Pap smear looks for signs of cervical cancer. Your doctor may let you have smears more infrequently after three consecutive normal Pap tests. This interval can also be extended in older women with a negative HPV test.
Women should also be tested for sexually transmitted diseases (STDs) based on individual risk factors and age recommendations.
Screening for breast cancer
Breast cancer screening consists of clinical exams and screening mammograms. If you have family members with breast cancer, your doctor will screen you to see if you are at risk for more dangerous types of breast cancer that are linked to certain genes (BRCA1 or BRCA 2). If you’re at risk, your doctor may recommend genetic counseling or BRCA testing.
You should have two physicals during your 20s. At each exam, your doctor should perform a careful head-to-toe assessment and check your:
- body mass index (BMI)
Your doctor may also ask you questions about:
- alcohol and drug use
- diet and exercise
- vaccination history
- intimate partner violence
Women aged 20 and older should get a baseline screening for cholesterol levels and triglycerides if they are at risk for coronary heart disease. The American Heart Association recommends women get checked every four to six years, starting at age 20. After age 45, screening for cholesterol becomes important, as heart disease risk increases with age.
Blood pressure screening
A diagnosis of hypertension, or high blood pressure, is made if your blood pressure is higher than 140/90. Because high blood pressure can lead to other complications, it should be checked every two years if it’s 120/80 or under. If it’s higher, your doctor may recommend having it checked more often. If you are diagnosed with high blood pressure, you should also be screened for diabetes.
Get vision screenings every other year if you wear contacts or glasses. If you don’t have vision problems, screening may not be necessary. However, you should see an eye doctor if you have any concerns.
You should visit the dentist every year for an exam and cleaning.
You should get a flu vaccine every year, especially if you are over the age of 65 or have risk factors that make you more susceptible to infection.
You should get one tetanus-diphtheria booster every 10 years, starting sometime after age 19.
If you are younger than 26, you should consider the HPV vaccine.
If you have never had chickenpox, you should get the varicella vaccine.
40s to 60s
The tests you began in your 20s will still be used in your 40s, though the timing of the exams will change. You should:
- have an eye exam every two years, even if you don’t wear glasses
- have physical exams every one to five years
- get a professional breast exam every year
- consider getting a shingles vaccine after the age of 60
You will also need several new tests starting in your 40s.
All women should have a mammography to screen for breast cancer. How often you seek treatment varies by age. The U.S. Preventive Services Task Force recommends mammograms every other year for women between 50 and 74 years old. Women younger than age 50 should work with their doctors to determine how often to have a mammography.
For women over age 75, there is no recommendation because not enough research has been done on the impacts of mammography on women in this age group.
Starting in your 40s, your healthcare provider will perform yearly breast exams. They will visually and manually check your breasts for differences in size or shape, rashes and dimpling, and lumps. They may also check to see if your nipples produce fluid when gently squeezed.
You should be aware of how your breasts look and feel and report any changes to your physician.
Colon cancer screening
Once you turn 50, you should start being screened for colon cancer. Possible tests include a:
- yearly stool test
- flexible sigmoidoscopy (every five years)
- colonoscopy (every 10 years)
- double-contrast barium enema (every five years)
- computed tomographic colonoscopy (every five years)
You may need screening more often if you are at high risk of colon cancer. You should be screened for this until age 75.
According to the American Cancer Society, about 3.3 million Americans are diagnosed with skin cancer each year. To catch it early, check yourself once a month starting at age 18 by looking for new or suspicious moles. Screenings by a medical professional are based on a patient’s risk factors.
These risk factors may include:
- significant sun exposure
- family history of skin cancer
- fair skin
- the presence of multiple unusual moles
- a history of several blistering sun burns, especially early in life
Timing for screening tests continues to change as you grow older. For example, your blood pressure should now be checked yearly.
Your cholesterol should be checked every three to five years, or more often if it’s abnormal.
Bone density test
Women age 65 and older should be screened for osteoporosis. If you have ever had a fracture, you should have a bone density test once you go through menopause. You should also have this test if you are under 65 and have high fracture risk.
An audiogram is a check of your hearing at various pitches and intensity levels. You may need one once a year.
This is a series of two vaccines, administered a year apart. It is recommended that people over age 65 get vaccinated against pneumonia.
Based on your health, your doctor may order other screening tests to supplement the standard age-based tests.
The National Alliance on Mental Illness estimates that 16 million American adults had at least one major depressive episode in the last year. They add that women are 70 percent more likely than men to experience depression. If you’re concerned about your mood, ask your doctor for this screening. Your doctor will ask questions about symptoms, such as:
- sleep troubles
- loss of libido or sexual interest
- loss of interest in usual activities
If you are at high risk of diabetes, you may need to be screened for prediabetes and diabetes every three years starting in your 40s. If your blood pressure is over 135/80 or you have high cholesterol levels your doctor may screen you for type 2 diabetes.
Diabetes risk factors include:
- physical inactivity
- severe obesity
- having a first-degree relative with diabetes
- being African-American, Mexican-American, American Indian, Native Hawaiian, Pacific Islander, or Asian-American