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Health Screening Guidelines for Women 40 to 49

A screening test is done to find possible health problems or diseases in people who don't have any symptoms. The goal is to find a disease early so lifestyle changes can be made and you can be watched more closely to lower the risk of disease, or to find it early enough to treat it most effectively. Screening tests are not diagnostic. But they are used to find out if more testing is needed. Health counseling is vital, too. This plan does not include recommendations for pregnancy. You and your healthcare provider may decide that a different schedule is best for you. Major health groups may vary in their advice. But this plan can guide your discussion.

Gender words are used here to talk about anatomy and health risk. Please use this information in a way that works best for you and your provider as you talk about your care

Screening	Who needs it	How often
Type 2 diabetes or prediabetes	All adults starting at age 35 and adults with no symptoms at any age who are overweight or obese and have 1 or more additional risk factors for diabetes	At least every 3 years
Alcohol misuse	All adults	At routine exams
Blood pressure	All adults	Yearly checkup if your blood pressure is normal. Normal blood pressure is less than 120/80 mmHg. If your blood pressure reading is higher than normal, follow the advice of your healthcare provider.
Breast cancer	All women	Screening with a mammogram every year is an option starting at age 40. Talk with your healthcare provider about your recommended frequency depending on your risk factors.
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 precancer	Women between ages 30 and 65 may choose any of the following test approaches: Pap test plus an HPV test (called "co-testing") every 5 years Pap test alone every 3 years Primary HPV testing every 5 years
Colorectal cancer	Women of average risk ages 45 years and older	Several tests are available and used at different times. Tests that find polyps and cancer include: Colonoscopy every 10 years (recommended) Flexible sigmoidoscopy every 5 years, or CT colonography (virtual colonoscopy) every 5 years Tests that primarily find cancer include: Yearly fecal occult blood test, or Yearly fecal immunochemical test every year, or Stool fecal immunochemical test with DNA test, every 3 years You will need a follow-up colonoscopy if you choose any test other than a colonoscopy and you have an abnormal result. Screening recommendations vary among expert groups. Talk with your healthcare provider about which test is best for you. Some people should be screened using a different schedule because of their personal or family history. Talk with your provider about your health history and what colorectal cancer screening schedule is best for you.
Chlamydia	Women at a higher 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
Gonorrhea	Sexually active women at a higher risk for infection	At routine exams if at risk
Hepatitis C	Adults at a higher risk; 1 time for those born between 1945 and 1965	At routine exams if at risk
HIV	All women	At routine exams
Lipid disorders	All women age 45 and older at a higher risk for coronary artery disease For women ages 19 to 44, screening should be based on risk factors; talk with your healthcare provider	At least every 5 years
Obesity	All adults	At routine checkups
Syphilis	Women at a higher risk for infection	At routine exams if at risk
Tuberculosis	Adults at a higher risk for infection	Check with your healthcare provider.
Vision	All adults	Baseline comprehensive exam at age 40; if you have a chronic disease, check with your healthcare provider for exam frequency.

Screening

Who needs it

How often

Type 2 diabetes or prediabetes

All adults starting at age 35 and adults with no symptoms at any age who are overweight or obese and have 1 or more additional risk factors for diabetes

At least every 3 years

Alcohol misuse

All adults

At routine exams

Blood pressure

All adults

Yearly checkup if your blood pressure is normal.

Normal blood pressure is less than 120/80 mmHg.

If your blood pressure reading is higher than normal, follow the advice of your healthcare provider.

Breast cancer

All women

Screening with a mammogram every year is an option starting at age 40. Talk with your healthcare provider about your recommended frequency depending on your risk factors.

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 precancer

Women between ages 30 and 65 may choose any of the following test approaches:

Pap test plus an HPV test (called "co-testing") every 5 years
Pap test alone every 3 years
Primary HPV testing every 5 years

Colorectal cancer

Women of average risk ages 45 years and older

Several tests are available and used at different times.

Tests that find polyps and cancer include:

Colonoscopy every 10 years (recommended)
Flexible sigmoidoscopy every 5 years, or
CT colonography (virtual colonoscopy) every 5 years

Tests that primarily find cancer include:

Yearly fecal occult blood test, or
Yearly fecal immunochemical test every year, or
Stool fecal immunochemical test with DNA test, every 3 years

You will need a follow-up colonoscopy if you choose any test other than a colonoscopy and you have an abnormal result. Screening recommendations vary among expert groups. Talk with your healthcare provider about which test is best for you.

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

Chlamydia

Women at a higher 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

Gonorrhea

Sexually active women at a higher risk for infection

At routine exams if at risk

Hepatitis C

Adults at a higher risk; 1 time for those born between 1945 and 1965

At routine exams if at risk

HIV

All women

At routine exams

Lipid disorders

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

For women ages 19 to 44, screening should be based on risk factors; talk with your healthcare provider

At least every 5 years

Obesity

All adults

At routine checkups

Syphilis

Women at a higher risk for infection

At routine exams if at risk

Tuberculosis

Adults at a higher risk for infection

Check with your healthcare provider.

Vision

All adults

Baseline comprehensive exam at age 40; if you have a chronic disease, check with your healthcare 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 a higher risk	When risk is identified
Diet and exercise	Adults who are overweight or obese	When diagnosed and at routine exams
Intimate partner violence	Women of child-bearing age and older women with a higher risk	At routine exams
Sexually transmitted infection prevention	Adults at a higher risk for infection	At routine exams
Tobacco use and tobacco-related disease	All adults	Every exam

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 a higher risk

When risk is identified

Diet and exercise

Adults who are overweight or obese

When diagnosed and at routine exams

Intimate partner violence

Women of child-bearing age and older women with a higher risk

At routine exams

Sexually transmitted infection prevention

Adults at a higher risk for infection

At routine exams

Tobacco use and tobacco-related disease

All adults

Every exam

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Health Screening Guidelines for Women 40 to 49

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