Prevention Guidelines

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 signoidoscopy 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 during flu season
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. 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. 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

Immunization schedule from the CDC