Prevention Guidelines for Women 50-64

Here are the screening tests and immunizations that most women ages 50 to 64 need. Although you and your health care provider may decide that a different schedule is best for you, this plan can guide 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, and

Yearly if systolic blood pressure reading of 120 to 139 mm Hg or diastolic blood pressure of 80 to 89 mm Hg

Breast cancer

All women

Yearly mammogram and clinical breast exam*

Cervical cancer

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

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

Colorectal cancer

All adults starting at age 50

According to the American Cancer Society:

For tests that find polyps and cancer:

  • Flexible signoidoscopy every 5 years1, or

  • Colonoscopy every 10 years, or

  • Double-contrast barium enema every 5 years1

For tests that primarily find cancer:

  • Yearly fecal occult blood test2, or

  • Yearly fecal immunochemical test every year2, or

  • 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.

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 are asymptomatic with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg

At routine exams

Gonorrhea

Sexually active women at increased risk for infection

At routine exams

HIV

Anyone at increased risk for infection

At routine exams

Lipid Disorders

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

At least every five years

Obesity

All adults

At routine exams

Osteoporosis, Postmenopausal Women

An update to this recommendation is currently in progress and being reviewed by the USPSTF. The recommendation below may contain information that is out of date. Please discuss with your health care provider.

Women at age 60 who are at increased risk for osteoporotic fractures

Please consult your health care provider.

Syphilis

Anyone at increased risk for infection

At routine exams

Tuberculosis

Anyone at increased risk for infection

Check with your health care provider.

Counseling

Who needs it

How often

Aspirin for prevention of cardiovascular events

At-risk adults

Recommended for women age 55 to 79 years when the potential benefit of a reduction in ischemic strokes outweighs the potential harm of an increase in gastrointestinal hemorrhage.

When risk is identified, and please discuss with your health care provider.

Breast cancer, chemoprevention

An update to this recommendation is currently in progress and being reviewed by the USPSTF. The recommendation below may contain information that is out of date. Please discuss with your health care provider.

Women with high risk

The recommendation below may contain information that is out of date. Please consult your health care provider.

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-Caused 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 - Once after age 18

Measles, mumps, rubella (MMR)

All adults age 50 to 64 who lack prior infection or documented vaccinations**

One dose

Chickenpox (varicella)

Adults age 50 to 64 and who lack prior infection or documented vaccinations**

Two doses. The second dose should be administered four to eight weeks after the first dose.

Flu vaccine (seasonal)

All adults

Yearly during flu season

Hepatitis A vaccine

People at risk**

Two doses

Schedule:

Zero and 6 to 12 months (Havrix), OR

Zero and 6 to 18 months schedule (Vaqta)

Hepatitis B vaccine

People at risk**

Three doses over six months

Second dose should be administered one month after the first dose; the third dose should be administered at least two months after the second dose (and at least four months after the first dose)

Meningococcal

People at risk**

One or more doses

Pneumococcal (polysaccharide)

People at risk**

One or two doses

Zoster

All women age 60 and older**

One dose