Recommendations apply to most women of normal risk. Additional tests and immunizations may be recommended based on specific risk factors. Visits are recommended every one–to–three years and should include the following, based on age.

Health History and Lifestyle Assessment

Complete or update assessment, including family history; activity; tobacco, alcohol, and drug use; and sexual practices

Physical Exam

  • Height and weight (Body Mass Index)
  • Blood pressure
  • Hearing and vision screening

Tests

  • Screen for lipid disorders every five years
  • Colorectal cancer screening using fecal occult blood testing, multi-targeted stool DNA test (e.g., Cologuard), sigmoidoscopy, or colonoscopy beginning at age 45 and continuing until age 75. Talk with your doctor regarding the frequency of screening needed
  • Cervical cancer screening by Pap test is optional after age 65; discuss with your doctor
  • Breast cancer screening by mammogram every one-to-two years until age 74; then as indicated after age 74
  • Osteoporosis screening for women ages 65 and up
  • Screen for Type 2 diabetes if blood pressure > 135/80
  • Screen for abnormal blood glucose and Type 2 diabetes,  age 40–70 years who are overweight or obese

Immunizations

  • One-time dose Tetanus/Diphtheria/Pertussis; Tetanus/Diphtheria booster every 10 years
  • Flu vaccine annually
  • Pneumococcal vaccine once in a lifetime from age 65; booster as recommended
  • Shingles (Herpes Zoster) vaccine for ages 60 and up unless contraindicated
  • Varicella vaccine for those without evidence of prior infection

Counseling/Screening

  • Diet: discuss calcium and vitamin D
  • Exercise promotion
  • Menopause management
  • Smoking cessation
  • Alcohol/substance abuse prevention
  • Sexually transmitted diseases/HIV/sexual behavior
  • Dental health
  • Sun exposure
  • Injury prevention (including seat belt, helmet use, and falls)
  • Life stage issues: bereavement
  • Depression
  • Health Care Proxy/Advance Directives
  • Bladder control problems
  • Screen for HIV infection ages 15–65
  • One time screening for HCV infection to adults born 1945–1965
  • Family violence

High-Risk Individuals

  • Aspirin therapy recommended for ages 55–79 when benefit outweighs risks
  • Screen for syphilis infection
  • Screen for latent tuberculosis infection for asymptomatic adults
  • For additional vaccine recommendations, visit cdc.gov/vaccines/schedules/hcp/adult.html

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