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    Prevention Guidelines for Women 40–49

    A screening test is done to find possible health problems or diseases in people who don't have any symptoms. The goal is to find a disease early so lifestyle changes can be made and you can be watched more closely to lower the risk of disease, or to find it early enough to treat it most effectively. Screening tests are not diagnostic. But they are used to find out if more testing is needed. Health counseling is vital, too. This plan does not include recommendations for pregnancy. You and your healthcare provider may decide that a different schedule is best for you. But this plan can guide your discussion.

    Screening

    Who needs it

    How often

    Type 2 diabetes or prediabetes

    All adults starting at age 45 and adults with no symptoms at any age who are overweight or obese and have 1 or more additional risk factors for diabetes

    At least every 3 years

    Alcohol misuse

    All adults

    At routine exams

    Blood pressure

    All adults

    Yearly checkup if your blood pressure is normal.

     

    Normal blood pressure is less than 120/80 mmHg.1

     

    If your blood pressure reading is higher than normal, follow the advice of your healthcare provider.

     

    Breast cancer

    All women2

    Screening with a mammogram every year is an option starting at age 40. Talk to your healthcare provider regarding your recommended frequency depending on your risk factors.

    Cervical cancer

    All women, except those who had a hysterectomy (with removal of the cervix) for reasons not related to cervical cancer and 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.

    Colorectal cancer

    Women of average risk ages 45 years and older

    Several tests are available and used at different times.

    Tests include:

    • Flexible sigmoidoscopy every 5 years, or

    • CT colonography (virtual colonoscopy) every 5 years, or

    • Colonoscopy every 10 years, or

    • Yearly fecal occult blood test, or

    • Yearly fecal immunochemical test every year, or

    • Stool DNA test, every 3 years

    You will need a follow-up colonoscopy if you choose any test other than a colonoscopy and you have an abnormal result. Screening recommendations vary among expert groups. Talk with your doctor about which test is best for you.

    Some people should be screened using a different schedule because of their personal or family history. Talk with your doctor about your health history and what colorectal cancer screening schedule is best for you.

    Chlamydia

    Women at a higher risk for infection

    At routine exams if at risk

    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

    Gonorrhea

    Sexually active women at a higher risk for infection

    At routine exams if at risk

    Hepatitis C

    Adults at a higher risk; 1 time for those born between 1945 and 1965

    At routine exams if at risk

    HIV

    All women

    At routine exams

    Lipid disorders

    All women age 45 and older at a higher risk for coronary artery disease

    For women ages 19 to 44, screening should be based on risk factors; talk with your healthcare provider

    At least every 5 years

    Obesity

    All adults

    At routine checkups

    Syphilis

    Women at a higher risk for infection

    At routine exams if at risk

    Tuberculosis

    Adults at a higher risk for infection

    Check with your healthcare provider.

    Vision

    All adults3

    Baseline comprehensive exam at age 40; if you have a chronic disease, check with your healthcare provider for exam frequency.

    Counseling

    Who needs it

    How often

    Breast cancer, chemoprevention

    Women at high risk

    When risk is identified

    BRCA mutation testing for breast and ovarian cancer susceptibility

    Women with a higher risk

    When risk is identified

    Diet and exercise

    Adults who are overweight or obese

    When diagnosed and at routine exams

    Domestic violence

    Women of child-bearing age and older women with a higher risk

    At routine exams

    Sexually transmitted disease prevention

    Adults at a higher risk for infection

    At routine exams

    Tobacco use and tobacco-related disease

    All adults

    Every exam

    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

    Chickenpox (varicella)

    All adults in this age group who have no record of previous infection or vaccinations

    2 doses; the second dose should be given at least 4 weeks after the first dose

    Measles, mumps, rubella (MMR)

    All adults in this age group who have no record of previous infection or vaccinations

    1 or 2 doses

    Flu vaccine (seasonal)

    All adults

    Yearly, when the vaccine becomes available in the community

    Hepatitis A vaccine

    People at risk4

    2 doses given 6 months apart

    Hepatitis B vaccine

    People at risk5

    3 doses; the 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).

    Haemophilus influenzae type B (HIB)

    People at risk

    1 to 3 doses

    Meningococcal

    People at risk**

    1 or 2 doses

    Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23)

    People at risk6

    1 or 2 doses

    1. American College of Cardiology and the American Heart Association Task Force on Clinical Practice Guidelines

    2. American Cancer Society

    3. Recommendation from the American Academy of Ophthalmology

    4. For complete list, see the CDC website

    5. Exceptions may exist. Please talk with your healthcare provider.

    Other guidelines from the USPSTF

    Immunization schedule from the CDC

    Online Medical Reviewer: Adler, Liora C, MD
    Online Medical Reviewer: Cunningham, Louise, RN
    Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
    Date Last Reviewed: 6/1/2018
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