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Preventive Care Guidelines

Preventive Care For Women 40-49

Below are the screening tests and immunizations that most women ages 40 to 49 need. This plan does not include recommendations for pregnancy. You and your health care provider may decide that a different preventive care plan is best for you, this guide can help 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 had a hysterectomy (with removal of the cervix) for reasons not related to cervical cancer and no history of cervical cancer or serious pre-cancer 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 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
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 checkups
Lipid disorders All women age 45 and older at increased risk for coronary artery disease

For women ages 19 to 44, screening should be based on risk factors1; discuss with your health care provider

At least every 5 years
Obesity All adults At routine checkups
Syphilis Women 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 adults2 Baseline comprehensive exam at age 40; if you have a chronic disease, check with your health care 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 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

Chickenpox (varicella) All adults ages 19 to 49 who have no documentation of previous infection or vaccinations Two doses; the second dose should be given at least 4 weeks after the first dose
Measles, mumps, rubella (MMR) All adults ages 19 to 49 who have no documentation of previous infection or vaccinations One or two doses
Flu vaccine (seasonal) All adults Yearly, when the vaccine becomes available in the community
Hepatitis A vaccine People at risk3 Two doses given 6 months apart
Hepatitis B vaccine People at risk4 Three 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)
Meningococcal People at risk** One or more doses
Pneumococcal (polysaccharide) People at risk5 One or two doses

 

*Recommendation from the American Cancer Society (ACS). Currently, the U.S. Preventive Services Task Force (USPSTF) recommends screening every 2 years for women ages 50 to 74. 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. The USPSTF, however, believes there is not enough evidence to assess the value of 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 discuss with your health care provider

1Recommendation from the American Congress of Obstetricians and Gynecologists

2Recommendation from the American Academy of Ophthalmology

3For complete list, see the CDC website

4For complete list, see the CDC website

5For complete list, see the CDC website

Immunization schedule from the CDC