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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:
|
| 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