Prevention Guidelines for Women 65+

Here are the screening tests and immunizations that most women at age 65 and older 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

Every two years if your blood pressure reading is less than 120/80 mm Hg1

Yearly if your systolic blood pressure reading is 120 to 139 mm Hg or your diastolic blood pressure reading is 80 to 89 mm Hg1

Breast cancer

All women2

Yearly mammogram and clinical breast exam2

Cervical cancer

According to the American Cancer Society (ACS), women older than 65 who have had regular screening with normal results should not be screened for cervical cancer. Once screening is stopped, it should not be started again.

Discuss with your health care provider3

Chlamydia

Women at increased risk for infection

At routine exams

Colorectal cancer

All adults ages 50 and older

The ACS recommends:

For tests that find polyps and cancer:

  • Flexible sigmoidoscopy every 5 years6, or

  • Colonoscopy every 10 years, or

  • Double-contract barium enema every 5 years6, or

  • CT colonography (virtual colonoscopy) every 5 years6

For tests that primarily find cancer:

  • Yearly fecal occult blood test7, or

  • Yearly fecal immunochemical test every year7, or

  • Stool DNA test, interval uncertain7

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.

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

Depression

All adults who have access to a clinical practice that has 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 and have sustained blood pressure (treated or untreated) greater than 135/80 mm Hg

At routine exams

Gonorrhea

Sexually active women who are at increased risk for infection

At routine exams

HIV

Anyone at increased risk for infection

At routine exams

Lipid disorders

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

At least every five years4

Obesity

All adults

At routine exams

Osteoporosis, postmenopausal

Women ages 65 and older5

Bone density test at age 655

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

Women ages 55 to 79 when the potential benefits from a reduction in ischemic strokes outweigh the potential harm from an increase in gastrointestinal hemorrhage

Discuss with your health care provider

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

Measles, mumps, rubella (MMR)

All adults age 65 and older who lack prior infection or documented vaccinations*

One dose

Chickenpox (varicella)

All adults age 65 and older who lack prior infection or documented vaccinations*

Two doses; second dose should be given 4 to 8 weeks after the first dose

Flu (seasonal)

All adults

Yearly during flu season

Hepatitis A vaccine

People at risk*

Two doses: For Havrix, at zero and 6 to 12 months; or for Vaqta, at zero and 6 to 18 months

Hepatitis B vaccine

People at risk*

Three doses; the second dose should be given one to two months after the first dose and the third dose given six months after the first dose

Meningococcal

People at risk*

One or more doses

Pneumococcal (polysaccharide)

All adults

One dose

Zoster

All women age 65 and older

One dose