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Screening
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Who needs it
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How often
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Alcohol misuse
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All adults
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At routine exams
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Blood pressure
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All adults
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Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends the following screening schedules:
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Every 2 years if blood pressure reading < 120/80 mm Hg, or
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Yearly if systolic blood pressure reading of 120 to 139 mm Hg or diastolic blood pressure reading of 80 to 89 mm Hg
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Breast cancer
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All women
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Yearly mammogram and clinical breast exam*
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Cervical cancer
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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
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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.
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Chlamydia
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Women at increased risk for infection
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At routine exams
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Colorectal cancer
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All adults starting at age 50
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According to the American Cancer Society (ACS):
For tests that find polyps and cancer:
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Flexible signoidoscopy every 5 years1, or
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Colonoscopy every 10 years, or
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Double-contrast barium enema every 5 years1
For tests that primarily find cancer:
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Yearly fecal occult blood test2, or
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Yearly fecal immunochemical test every year2, or
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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
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Depression
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All adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up
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At routine exams
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Diabetes mellitus, type 2
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Adults who have no symptoms and have sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg
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At least every 3 years
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Gonorrhea
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Sexually active women at increased risk for infection
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At routine exams if at risk
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HIV
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Anyone at increased risk for infection
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At routine exams if at risk
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Lipid disorders
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All women ages 45 and older at increased risk for coronary artery disease
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At least every 5 years
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Obesity
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All adults
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At routine exams
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Osteoporosis, postmenopausal women
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Women at age 60 who are at increased risk for fractures caused by osteoporosis
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Check with your health care provider
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Syphilis
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Anyone at increased risk for infection
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At routine exams if at risk
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Tuberculosis
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Anyone at increased risk for infection
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Check with your health care provider
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Vision
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All adults3
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Check with your health care provider for exam frequency
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Counseling
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Who needs it
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How often
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Aspirin for prevention of cardiovascular problems
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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
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When risk is identified; discuss with your health care provider before starting
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Breast cancer, chemoprevention
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Women at high risk
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When risk is identified
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BRCA mutation testing for breast and ovarian cancer susceptibility
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Women with increased risk
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When risk is identified
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Diet, behavioral counseling
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Adults with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease
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When diagnosed
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Tobacco use and tobacco-related disease
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All adults
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Every visit
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Immunization
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Who needs it
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How often
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Tetanus/diphtheria/pertussis (Td/Tdap) booster
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All adults
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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
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Measles, mumps, rubella (MMR)
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All adults ages 50 to 64 who have no previous infection or documented vaccinations**
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One dose
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Chickenpox (varicella)
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Adults ages 50 to 64 who have no previous infection or documented vaccinations**
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Two doses; the second dose should be given at least 4 weeks after the first dose
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Flu vaccine (seasonal)
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All adults
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Yearly during flu season
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Hepatitis A vaccine
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People at risk4
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Two doses given at least 6 months apart
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Hepatitis B vaccine
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People at risk5
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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)
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Meningococcal
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People at risk**
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One or more doses
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Pneumococcal (polysaccharide)
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People at risk6
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One or two doses
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Zoster
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All women ages 60 and older**
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One dose
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