Be proactive about your health
Health screenings — physical exams, tests and procedures used to detect disease early — are important. Screening tests are designed to detect hidden disease in otherwise healthy people. From mammograms to colonoscopies and Pap smears, these are the 14 screenings all women need, according to experts.
Keep in mind that the benefits and risks of screening tests and procedures change as you get older. Your doctor can help you tailor the recommendations below based on your goals of care, personal and family health history, age and life expectancy.
Cervical exam with PAP test and HPV test
All women need regular check-ups with their OB-GYN to examine their vagina and cervix starting at age 13 to 15, says Shannon Clark, an associate professor in the Division of Maternal-Fetal Medicine at University of Texas Medical Branch Hospitals. Frequency varies until age 21, when appointments — which cater to preventive health services — may vary, though annual screening is common.
The United States Preventive Services Task Force recommends a Pap smear every three years for women 21 to 65 who have a cervix. At age 30, a Pap test and HPV test every 5 years is an option. If you are 65 or older, ask your doctor or nurse if you need to keep having Pap tests.
“It’s very important that all women establish care with an OB-GYN and be routinely seen,” Clark says.
During a Pap smear, cells are scraped from the opening of the cervix to screen for cervical cancer.
“Any mild irregularities will prompt an HPV test to check for the high-risk strains of the HPV virus,” says Keri Peterson, an internist based in New York.
Human papillomavirus, the most common STD in the U.S., causes cervical and other types of cancer. An HPV test — often done at the same time as a Pap smear — is recommended every five years for women ages 30 to 65. Since HPV is so common in women under 30, and experts say it often goes away on its own, the test typically isn’t recommended for this age group unless there’s an abnormal Pap test result.
History and physical exam
Schedule an annual visit with your primary care physician to identify any health risks before symptoms begin to develop. Your doctor will complete a physical exam and ask you questions about your health habits, prior illnesses, family history and your health goals. Your doctor will ask you about alcohol and drug use. They may also ask you about safety and counsel you on cancer prevention.
“History changes for everyone,” says Mary Rosser, an obstetrician and gynecologist at Columbia University Irving Medical Center. In addition to reviewing changes in family history, doctors should inquire about menstrual history, sexual practices and orientation, social habits and emotional, physical and sexual abuse. The other component — the physical exam — is an opportunity to assess blood pressure, weight and body mass index.
Have your blood pressure tested at least every once every two years if it is in the healthy range (under 120/80) or once a year if it is above normal (between 120/80 and 139/89).
Get tested for diabetes if your blood pressure is higher than 135/80 or if you take medicine for high blood pressure. Diabetes is common and increasing in our community for a variety of reasons. Your doctor may suggest a blood test if you are at risk.
Starting at age 20, women at increased risk for developing heart disease should have regular blood cholesterol tests.
Breast cancer screening
Experts do not agree about the benefits of breast self-exams in finding breast cancer or saving lives. Nevertheless, self-checks are easy to do at home — and you ought to check for lumps every month or so. Talk to your provider about what is best for you.
Mammograms are key to the prevention — and early detection — of breast cancer. This is a low-dose X-ray exam of the breasts, and beginning at age 40, women should undergo yearly mammograms. If you’re at high risk — with a family history of breast cancer, for example — your doctor may recommend earlier mammograms. Talk with your doctor about options if you have dense breasts.
A screening mammogram is not recommended for most women under age 40. Your provider may discuss and recommend mammograms, MRI scans, or ultrasounds if you have an increased risk for breast cancer, such as:
— A mother or sister who had breast cancer at a young age (most often starting screening earlier than the age the close relative was diagnosed)
— You carry a high-risk genetic marker.
A mammography is recommended every two years for women ages 50 to 74. If you are 75 or older, ask your doctor or nurse if you need to continue having mammograms.
STD screening
All women need to be screened for sexually transmitted diseases once they become sexually active. In addition to HIV, some patients with risk factors should be screened periodically for sexually transmitted infections including syphilis, gonorrhea and chlamydia. Early detection and treatment can prevent disease progression and complications later on.
Get tested for chlamydia yearly through age 24 if you are sexually active or pregnant. After 25, screening depends on risk factors or symptoms; get tested for chlamydia and other sexually transmitted diseases if you are at increased risk for getting a sexually transmitted infection.
Screening consists of a cervical culture or urine test for gonorrhea and chlamydia, and a blood test for HIV.
Colorectal cancer
A colonoscopy can lead to the early detection and treatment of colon cancer, which is the third most common cancer diagnosed in both men and women in the U.S. The screening should start at age 13 to 18 for those with pancolitis or who have a history of familial adenomatous polyposis — a genetic condition that’s diagnosed when someone develops more than 100 adenomatous colon polyps.
Women ages 19 to 49, meanwhile, should be screened if they’re high risk — which includes having inflammatory bowel disease or Crohn’s disease. In general, women should undergo a colonoscopy every 10 years starting at age 50, or age 45 for African-Americans, who have increased incidence and earlier age of onset.
Talk to your doctor about which screening test, (fecal occult blood testing, sigmoidoscopy, or colonoscopy) or combination of tests, is best for you and how often you need it and if you should continue having these tests after 75.
Diabetes
Beginning at age 45, women should be screened for diabetes every three years, Rosser says — and earlier if someone is at high risk with factors such as obesity or family history. The disease is “the leading cause of heart disease and on the rise in the U.S. due to the obesity epidemic,” Rosser says. “Early intervention is crucial.”
Also, get tested for diabetes if your blood pressure is higher than 135/80 or if you take medicine for high blood pressure.
Testing is typically done via a fasting plasma glucose test or hemoglobin A1C test.
Lipid profile assessment
This panel of blood tests will assess your risk of developing heart disease, plus measure your cholesterol and triglyceride levels. Start at age 13 to 44 if you’re at high risk — for example, obese or have a genetic predisposition for heart disease.
Routine screening, repeated every five years, starts at age 45, Rosser says. “There are dietary changes which may reduce these levels,” she adds. “Medications are available if diet changes aren’t working.”
Hepatitis B and C
Women at high risk need to think about these screenings beginning at ages 13 to 18, Clark says. Hepatitis B risk factors, for example, include injection drug users, those born in countries where the prevalence of infection is 2% or greater and HIV-positive people. And risk of hepatitis C increases if you’ve been exposed to an infected needle, perhaps via tattoo; your birth mother had the disease; or you had a blood transfusion before 1992.
Screening frequency depends on your doctor’s recommendations.
Pelvic organ prolapse
About one-third of women are affected by pelvic organ prolapse or a similar condition over their lifetime, which means one or more of their pelvic organs — bladder, uterus, vagina, small bowel and rectum — stop working properly. Beginning at age 65, women should be screened yearly, Peterson says.
Often, patients are aware there’s a problem — and notice a change in bladder or bowel habits — but aren’t sure what it traces back to.
Bone density
Women ages 65 and up should have a bone density scan every two years, Rosser says. And if you have risk factors for osteoporosis — such as an eating disorder or sedentary lifestyle — your doctor may recommend the test at a younger age.
During a bone density scan, X-rays measure how many grams of calcium and other bone minerals are in a segment of bone; these tests often center on the spine, hip and forearm.
Depending on your family history, talk to your doctor or nurse about getting tested if you’re younger than 65 or if you’re concerned about your bone health about repeat testing.
Thyroid-stimulating hormone testing
This blood test checks for thyroid problems, such as hyperthyroidism or hypothyroidism. It should begin as recommended between ages 19 to 49 in high-risk women — such as those with an autoimmune disease or family history — and every five years starting at age 50, Clark says.
Skin cancer
Visit a dermatologist for a thorough skin cancer exam every other year, Peterson says — or sooner if you notice any suspicious spots.
“Once a month, check for any new or unusual spots. Remember A-B-C-D-E: asymmetry, border irregularity, uneven color, diameter bigger than 6 millimeters and evolving shape and size.”
Vision test
You know this test: It measures the smallest letters you can read on a standardized chart held 20 feet away. The American Optometric Association recommends eye exams at least once every two years, Peterson says — though annual eye exams are suggested for anyone with current vision problems.
After the basic test, you’ll likely look at an eye chart through a variety of lenses, which will help your doctor determine your glasses or contact lens prescription.
An eye exam every 2 to 4 years between ages 40 to 54 and every 1 to 3 years between ages 55 to 64 is recommended to screen for certain eye diseases. Your provider may recommend more frequent eye exams if you have vision problems or glaucoma risk.
Have an eye exam that includes an examination of your retina (back of your eye) at least every year if you have diabetes.
Electrocardiogram exam
Your doctor may perform an electrocardiogram depending on your risk factors. Electrodes are attached to the patient’s arms, chest and legs by wires to record the heart’s electrical activity. This exam identifies heart problems and monitors the heart’s health.
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14 Health Screening Tests Every Woman Should Have originally appeared on usnews.com
Update 05/01/24: This story was published at an earlier date and has been updated with new information.
