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 healthcare provider may decide that a different schedule is best for you, this plan can guide your discussion.
Screening | Who needs it | How often |
|---|---|---|
Type 2 diabetes or prediabetes | All adults beginning at age 45 and adults without 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 | 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 healthcare provider3 |
Chlamydia | Women at increased risk for infection | At routine exams if at risk |
Colorectal cancer | All women of average risk and in good health in this age group, through age 75. For women ages 76 to 85, talk with your healthcare provider about continued screening. For women 85 and older, experts don't advise screening. | The ACS recommends: Several tests are available and used at different times. For tests that find polyps and cancer:
For tests that primarily find cancer:
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 doctor 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 doctor about your health 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 |
Gonorrhea | Sexually active women who are at increased risk for infection | At routine exams if at risk |
HIV | Anyone at increased risk for infection | At routine exams if at risk |
Hepatitis C | Anyone at increased risk; 1 time for those born between 1945 and 1965 | At routine exams |
High cholesterol and triglycerides | All women ages 20 and older at increased risk for coronary artery disease | At least every 5 years, or more frequently if recommended by your healthcare provider6 |
Lung cancer | Adults age 55 to 80 who have smoked | Yearly screening in smokers with 30 pack per year history of smoking or who quit within 15 years |
Obesity | All adults | At routine exams |
Osteoporosis, postmenopausal | All women ages 65 and older7 | Bone density test at age 65, then follow-up as recommended by healthcare provider7 |
Syphilis | Anyone at increased risk for infection | At routine exams if at risk |
Tuberculosis | Anyone at increased risk for infection | Check with your healthcare provider |
Vision | All adults8 | Every 1 to 2 years; if you have a chronic disease, check with your healthcare provider for exam frequency |
Counseling | Who needs it | How often |
Aspirin for prevention of cardiovascular problems | Women ages 55 to 79 when the potential benefits from reducing ischemic strokes outweigh the potential harm from an increase in gastrointestinal hemorrhage | Discuss with your healthcare provider |
Diet and exercise | Adults who are overweight or obese | When diagnosed and at routine exams |
Fall prevention (exercise, vitamin D supplements) | All women in this age group | At routine exams |
Sexually transmitted diseases prevention | All women at increased risk | At routine exams |
Tobacco use and tobacco-related disease | All adults | Every exam |
Immunization | Who needs it | How often |
Tetanus/diphtheria/ | All adults | Td: Every 10 years Tdap is recommended if you are in contact with a child 12 months or younger. Either Td or Tdap can be used if you have no contact with infants. |
Chickenpox (varicella) | All adults age 65 and older who have no previous infection or documented vaccinations* | Two doses; second dose should be given at least 4 weeks after the first dose |
Flu (seasonal) | All adults | Yearly, when the vaccine becomes available in the community |
Hepatitis A vaccine | People at risk9 | Two doses given 6 months apart |
Hepatitis B vaccine | People at risk10 | Three doses; 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) |
Haemophilus influenzae Type B (HIB) | Women at increased risk for infection, talk with your healthcare provider | 1 to 3 doses |
Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23) | All adults age 65 and older | 1 dose of each vaccine |
Zoster | All women ages 60 and older | One dose |
1Recommendation from the Joint National Committee on Prevention, Detection, and Treatment of High Blood Pressure
2American Cancer Society
3The American Congress of Obstetricians and Gynecologists currently recommends that women ages 30 and older get a Pap test once every three years and that women with certain risk factors (or with increased risk) may need more frequent screening. It's reasonable to discontinue screening after three or more consecutive negative Pap tests and no abnormal results within the last 10 years once a woman turns 65 or 70.
4If the test is positive, a colonoscopy should be done
5The multiple stool take-home test should be used. One test done by the doctor in the office is not adequate for testing. A colonoscopy should be done if the test is positive.
6Recommendation from ACOG
7Recommendation by the USPSTF
8Recommendation from the American Academy of Ophthalmology
9For complete list, see the CDC website
10For complete list, see the CDC website
*Exceptions may exist; discuss with your healthcare provider
Other guidelines from the USPSTF
Immunization schedule from the CDC