Health screenings for women ages 40 to 64

Definition

You should visit your health care provider from time to time, even if you are healthy. The purpose of these visits is to:

Screen for medical issues
Assess your risk for future medical problems
Encourage a healthy lifestyle
Update vaccinations and other preventive care services
Help you get to know your provider in case of an illness

Alternative Names

Health maintenance visit - women - ages 40 to 64; Physical exam - women - ages 40 to 64; Yearly exam - women - ages 40 to 64; Checkup - women - ages 40 to 64; Women's health - ages 40 to 64; Preventive care - women - ages 40 to 64

Information

Even if you feel fine, you should still see your provider for regular checkups. These visits can help you avoid problems in the future. For example, the only way to find out if you have high blood pressure is to have it checked regularly. High blood sugar and high cholesterol levels also may not have any symptoms in the early stages. A simple blood test can check for these conditions.

There are specific times when you should see your provider or receive specific health screenings. The US Preventive Services Task Force publishes a list of recommended screenings. Below are screening guidelines for women ages 40 to 64.

BLOOD PRESSURE SCREENING

Have your blood pressure checked at least once every year. Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked. You can also check your blood pressure using the automated machines that are often located at local grocery stores and pharmacies.

Ask your provider if you need your blood pressure checked more often if:

You have diabetes, heart disease, kidney problems, or are overweight or have certain other health conditions
You have a first-degree relative with high blood pressure.
You are Black.
Your blood pressure top number is from 120 to 129 mm Hg, or the bottom number is from 70 to 79 mm Hg.
You had high blood pressure during a pregnancy.

If the top number is 130 mm Hg or greater, but lower than 140 mm Hg or the bottom number is 80 mm Hg or greater but lower than 90 mm Hg, this is considered to be stage 1 hypertension. Readings above these are considered to be stage 2 hypertension. Schedule an appointment with your provider to learn how you can reduce your blood pressure. Record your blood pressure numbers and bring this information to share with your provider.

BREAST CANCER SCREENING

Experts do not agree about the benefits of breast self-exams in finding breast cancer or saving lives. Talk to your provider about what is best for you.

Mammography is performed to screen women to detect early breast cancer when it is more likely to be cured. The recommendations of different expert organizations can differ.

Mammography is generally recommended for all women starting at age 40, repeated every 1 to 2 years.
Women with a family history of breast cancer should work with their health care provider to assess their risk of breast cancer. In some situations, additional testing may be considered.

Mammograms work best at finding breast cancer in women ages 40 to 74. It is not clear how well mammograms work at finding cancer in women age 75 and older.

If you have other risk factors for breast cancer, your provider may recommend an MRI scan for screening.

CERVICAL CANCER SCREENING

After starting cervical cancer screening:

Women ages 30 through 65 should be screened with either a Pap test every 3 years or the HPV test every 5 years or both tests every 5 years (called "cotesting").
Women who have been treated for precancer (cervical dysplasia) should continue to have Pap tests for 20 years after treatment or until age 65, whichever is longer.

If you have had your uterus and cervix removed (total hysterectomy), and you have not been diagnosed with cervical cancer or precancer (high grade cervical neoplasia), you do not need cervical cancer screening.

CHOLESTEROL SCREENING

Cholesterol screening should begin at:

Age 45 for women with no known risk factors for coronary heart disease
Age 20 for women with known risk factors for coronary heart disease

Repeat cholesterol screening should take place:

Every 5 years for women with normal cholesterol levels
More often if changes occur in lifestyle (including weight gain and diet)
More often if you have diabetes, heart disease, kidney problems, stroke, or blood flow problems in the legs or feet, or certain other conditions

Your provider may recommend testing more often if you are taking medicines to control high cholesterol.

COLORECTAL CANCER SCREENING

If you are under age 45, talk to your provider about getting screened. You should be screened if you have a strong family history of colon cancer or polyps. Screening may also be considered if you have risk factors such as a history of inflammatory bowel disease or polyps.

If you are age 45 to 75, you should be screened for colorectal cancer. There are several screening tests available:

A stool-based fecal occult blood (FOBT) or fecal immunochemical test (FIT) every year (colonoscopy is needed if results are positive)
A stool sDNA-FIT test every 1 to 3 years (colonoscopy is needed if results are positive)
Flexible sigmoidoscopy every 5 years or every 10 years with stool testing with FOBT or FIT done every year
CT colonography (virtual colonoscopy) every 5 years
Colonoscopy every 10 years

You may need a colonoscopy more often if you have risk factors for colorectal cancer, such as:

Ulcerative colitis
A personal or family history of colorectal cancer
A family history of inherited colorectal cancer syndromes such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (HNPCC)

DENTAL EXAM

Go to the dentist once or twice every year for an exam and cleaning. Your dentist will evaluate if you have a need for more frequent visits.

PREDIABETES AND TYPE 2 DIABETES SCREENING

You should be screened for prediabetes and type 2 diabetes starting at age 35. Screening should be repeated every 3 years if you are overweight and have obesity.

You should be tested more often if you have other risk factors for diabetes, such as:

You have a first-degree relative with diabetes.
You have high blood pressure, prediabetes, or a history of heart disease.
If you are overweight and have other risk factors, such as high blood pressure, and are planning to become pregnant.

EYE EXAM

Have an eye exam every 2 to 4 years ages 40 to 54 and every 1 to 3 years ages 55 to 64. 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.

IMMUNIZATIONS

Commonly needed vaccines include:

Flu shot: get one every year.
COVID-19 vaccine: ask your provider what is best for you.
Tetanus-diphtheria and acellular pertussis (Tdap) vaccine: have as one of your tetanus-diphtheria vaccines if you did not receive it as an adolescent.
Tetanus-diphtheria: have a booster (Td or Tdap) every 10 years.
Varicella vaccine: receive 2 doses if you never had chickenpox or the varicella vaccine and were born in 1980 or after.
Hepatitis B vaccine: receive 2, 3, or 4 doses, depending on your exact circumstances, if you did not receive these as a child or adolescent, until age 59.
Shingles (herpes zoster) vaccine: 2 doses at or after age 50.

Ask your provider if you should receive other immunizations if you have certain health problems that increase your risk for some diseases such as pneumonia.

INFECTIOUS DISEASE SCREENING

Screening for hepatitis C:

All adults ages 18 to 79 should get a one-time test for hepatitis C.
Pregnant people should be screened at every pregnancy.

Screening for human immunodeficiency virus (HIV): all people ages 15 to 65 should get a one-time test.

Depending on your lifestyle and medical history, you may need to be screened for infections such as syphilis, chlamydia, and other infections.

LUNG CANCER SCREENING

You should have an annual screening for lung cancer with low-dose computed tomography (LDCT) if all of the following are present:

You are age 50 to 80 years AND
You have a 20 pack-year smoking history AND
You currently smoke or have quit within the past 15 years

OSTEOPOROSIS SCREENING

If you are age 50 to 64 and have risk factors for osteoporosis, you should discuss screening with your provider.

Risk factors can include long-term steroid use, low body weight, smoking, heavy alcohol use, having a fracture after age 50, or a family history of hip fracture or osteoporosis.

PHYSICAL EXAM

All adults should visit their provider from time to time, even if they are healthy. The purpose of these visits is to:

Screen for diseases
Assess risk of future medical problems
Encourage a healthy lifestyle
Update vaccinations and other preventive care services
Maintain a relationship with a provider in case of an illness

Your blood pressure, height, weight, and body mass index (BMI) should be checked at each exam.

During your exam, your provider may ask you about:

Depression and anxiety
Diet and exercise
Alcohol and tobacco use
Safety issues, such as using seat belts and smoke detectors and intimate partner violence
Your medicines and risk for interactions

SKIN EXAM

Your provider may check your skin for signs of skin cancer, especially if you're at high risk. You may be at high risk if you:

Have had skin cancer before
Have close relatives with skin cancer
Have a weakened immune system

Professional organizations do not recommend for or against performing a skin self-exam.

References

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American College of Obstetricians and Gynecologists (ACOG) website. FAQ178: Mammography and other screening tests for breast problems. www.acog.org/patient-resources/faqs/gynecologic-problems/mammography-and-other-screening-tests-for-breast-problems. Updated July 2022. Accessed May 20, 2024.

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